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目的 研究妇女生殖道感染高危型人乳头状瘤病毒(HR-HPV)的载量与子宫颈上皮内瘤变(CIN)的关系。方法 收集参加横断面普查研究的1997名35～45岁已婚妇女的子宫颈脱落细胞,采用第二代杂交捕获试验(HC2)进行HPV DNA检测,病毒载量由样本的相对光单位(RLU)与标准阳性对照(PC)之比(RLU/PC)来衡量,按照log_(10)RLU/PC分为阴性(<0)、低度载量(0～1.12)、中度载量(1.13～2.23)和高度载量(2.24～3.37)。子宫颈病变按照病理诊断分为正常、CIN1、CIN2～3和子宫颈癌(SCC)。采用非条件多项式logistic回归分析病毒载量与子宫颈病变级别的关系。结果 100％(12/12)的SCC、97.3％(72/74)的CIN2-3、58.3％(74/127)的CIN1、11.5％(205/1784)的正常对象HR-HPV DNA检测阳性,各组阳性对象的中位log_(10)RLU/PC分别为2.60、2.32、2.18和1.18。从低度病毒载量与CIN1的危险比值比(OR)为3.8(1.9～7.3)至高度病毒载量与CIN2～3的OR值为865.9(200.1～3738.0),显示出感染病毒载量与子宫颈病变程度呈正相关(P<0.001)。结论 子宫颈HR-HPV病毒载量是影响SCC及癌前病变的重要危险因素。
Objective To study the relationship between the load of high risk human papilloma virus (HR-HPV) and cervical intraepithelial neoplasia (CIN) in women with genital tract infection. Methods A total of 1997 cervical exfoliative cells from 1997 to present in 35 women aged 35 to 45 who participated in the cross-sectional census were collected. HPV DNA was detected by the second generation hybridization capture test (HC2). The viral load was determined by the relative light unit (RLU) (0 ~ 1.12), moderate load (1 ~ 13 ~ 1), and negative control (0 ~ 1.12) according to the ratio of RLU / PC to the standard positive control (PC) 2.23) and height loading (2.24 ~ 3.37). Cervical lesions were divided into normal, CIN1, CIN2 ~ 3 and cervical cancer (SCC) according to pathological diagnosis. Non-conditional polynomial logistic regression analysis of the relationship between viral load and cervical lesions. Results The positive HR-HPV DNA was detected in 100% (12/12) SCC, 97.3% (72/74) CIN2-3, 58.3% (74/127) CIN1, 11.5% (205/1784) Median log_ (10) RLU / PC of positive subjects in each group were 2.60, 2.22, 2.18 and 1.18, respectively. The odds ratio (OR) between the low-level viral load and CIN1 ranged from 3.8 (1.9 ~ 7.3) to the high-level viral load to CIN2 ~ 3 with an OR of 865.9 (200.1 ~ 3738.0) Cervical lesions were positively correlated (P <0.001). Conclusion Cervical HR-HPV viral load is an important risk factor affecting SCC and precancerous lesions.