上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

人乳头状瘤病毒感染及整合状态与子宫颈病变的关系

秦广益，陶敏芳   

  1. 上海交通大学附属第六人民医院妇产科， 上海 200233
  • 出版日期:2014-06-28 发布日期:2014-06-30
  • 通讯作者: 陶敏芳, 电子信箱: taomf@126.com。
  • 作者简介:秦广益（1978—）， 男， 主治医师， 硕士; 电子信箱: bbqgy@163.com。
  • 基金资助:

    上海市科委基金（11411950103）

Relationship between status of human papillomavirus infection and integration and cervical lesions

QIN Guang-yi, TAO Min-fang   

  1. Department of Obstetrics and Gynecology, the Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2014-06-28 Published:2014-06-30
  • Supported by:

    Foundation of Science and Technology Commission of Shanghai Municipality，11411950103

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摘要：

目的 研究女性生殖道感染人乳头状病毒亚型谱及多重人乳头状病毒感染率、高危型人乳头状病毒（hr-HPV）负荷量、人乳头状病毒（HPV）16亚型的整合状态与子宫颈病变严重程度的关系。方法 对2009年1月1日—2011年12月31日在上海交通大学附属第六人民医院妇产科就诊的1 082例患者，采用PCR反向点杂交法、HC-Ⅱ方法和PCR方法检测其生殖道感染的HPV亚型谱、hr-HPV负荷量以及HPV16亚型的整合状态。结果 所有被检测者的生殖道中共检出19种HPV亚型，HPV感染者379例（35.03%），其中hr-HPV感染者310例（28.65%）。HPV最常见亚型为16、11、6、52、58和18型，感染率依次为12.57%、8.32%、7.95%、6.56%、5.54%和4.71%。女性生殖道感染的hr-HPV负荷量和多重感染率越高，患子宫颈高级别病变的风险越大（P<0.05，P<0.001）。子宫颈组织细胞中HPV16的混合和整合发生率与子宫颈病变严重程度呈正相关（r=0.812，P<0.001）。结论 HPV16、18、52和58亚型是威胁妇女生殖健康最常见的高危亚型；生殖道HPV的高多重感染率、hr-HPV的高负荷量、hr-HPV DNA的高整合率是子宫颈高度癌前病变、子宫颈癌发生的高危因素。

关键词: 人乳头状瘤病毒, 子宫颈病变, 基因型, 负荷量, 整合状态

Abstract:

Objective To explore the gene types of HPV that infects the genital tract of women and the relationships of multiple infections, hr-HPV load, integrated state of HPV16, and the severity of cervical lesions. Methods A total of 1 082 patients who received treatment in the Department of Obstetrics and Gynecology of Sixth People's Hospital, Shanghai Jiao Tong University during the period of 2009.1.1-2011.12.31 were selected. PCR-reverse dot blot, HC-Ⅱ, and multiplicitas real time PCR were adopted to detect the gene types of HPV that infected the genital tract of patients, hr-HPV load, and integrated state of HPV16. Results Nineteen gene types of HPV were detected from the genital tract of patients. Among 379 patients who were infected by HPV (35.03%), 310 of them were infected by hr-HPV (28.65%). The most common HPV types were HPV16, HPV11, HPV6, HPV52, HPV58, and HPV18. Their infection rates were 12.57%, 8.32%, 7.95%, 6.56%, 5.54%, and 4.71%, respectively. The higher the hr-HPV load of the genital tract of patients and the multiple infection rate, the risk of suffering serious cervical diseases was higher (P<0.05，P<0.001). The proportion of HPV16 integration in cervical tissue cells was positively correlated to the severity of cervical lesions (r=0.812，P<0.001). Conclusion The most common hr-HPV types that threat the female reproductive health are HPV16, HPV18, HPV52, and HPV58. The multiple infection rate of HPV in the genital tract, loading dose of hr-HPV, and proportion of HPV16 integration are high risk factors of suffering cervical precancerosis and cancer.

Key words: human papillomavirus, cervical lesions, genetype, loading dose, integrated state