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目的研究陕西省妇女宫颈不同病变人乳头状瘤病毒(HPV)感染状况及亚型分布特征。方法采用聚合酶链反应(PCR)体外扩增和DNA反向点杂交相结合的DNA芯片技术,对1 871例宫颈不同病变脱落细胞标本进行HPV基因分型检测。结果单一型别HPV感染在健康人群中前6位亚型为81、52、16、58、43和33型;慢性宫颈炎为16、81、43、42、11和58型;宫颈上皮内瘤变(CIN)为16、52、58、33、56和81型;宫颈鳞癌为16、58、18、52、33和56型。多重感染中HPV16亚型最为常见,占35.55%;其次为52和58型,分别占19.20%和17.30%。总体HPV多重感染常见亚型为16、58、52、18、56和33型,共占81.24%。在宫颈不同病变中仍以单一亚型感染最为常见,二重感染占多重感染的70.53%。宫颈鳞癌中主要存在HPV高危单一亚型(63.14%)、高危多重亚型(18.91%)和高低危多重亚型(17.95%)感染,与慢性宫颈炎和CIN相比,差异有统计学意义(P<0.01)。结论 HPV16、58、18、52、56和33亚型均应作为陕西省HPV预防的重点高危亚型。
Objective To study the distribution and status of human papillomavirus (HPV) infection in women with cervical lesions in Shaanxi province. Methods HPV genotyping was performed on 1871 exfoliated cells from different cervical lesions by polymerase chain reaction (PCR) amplification in vitro and DNA reverse dot blot hybridization. Results The first 6 subtypes of single-type HPV infection in healthy population were type 81, 52, 16, 58, 43 and 33, the chronic cervicitis was type 16,81, 43, 42, 11, and 58. Cervical intraepithelial neoplasia CIN was 16, 52, 58, 33, 56 and 81; squamous cell carcinoma of the cervix was 16, 58, 18, 52, 33 and 56. HPV16 subtypes were the most common among multiple infections, accounting for 35.55%, followed by 52 and 58, accounting for 19.20% and 17.30% respectively. The common HPV subtypes were 16, 58, 52, 18, 56 and 33, accounting for 81.24%. In different lesions of the cervix is still the most common infection with a single subtype, double infection accounted for 70.53% of multiple infections. In cervical squamous cell carcinoma, there were mainly single high-risk HPV (63.14%), high-risk multiple subtype (18.91%) and high and low risk subtypes (17.95%), which were significantly different from those of chronic cervicitis and CIN (P <0.01). Conclusion HPV16,58,18,52,56 and 33 subtypes should be regarded as the key high risk subtype of HPV prevention in Shaanxi Province.