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目的 探讨人乳头状瘤病毒 (HPV)负荷量与子宫颈癌及其癌前病变的关系。方法 2 0 0 1年 12月～ 2 0 0 2年 5月 ,对山西省宫颈癌高发现场的 90 75例 35～ 5 0岁的已婚妇女 ,采用杂交捕获二代(HC Ⅱ )方法定量检测宫颈HPV DNA的含量 (以此表示宫颈HPV负荷量 )。对其中HPV DNA阳性妇女 ,随后进行阴道镜检查、宫颈多点活检和颈管诊刮术。结果 2 0 87例HPV阳性妇女中 ,子宫颈炎14 0 2例 (6 7 2 % ) ,子宫颈癌前病变 [包括子宫颈上皮内瘤变 (CIN)Ⅰ～Ⅲ ]6 6 3例 (31 8% ) ,子宫颈浸润癌 (SCC) 2 2例 (1 1% )。急、慢性宫颈炎的HPV DNA含量分别为 10 8± 13和 15 0± 11,两者比较 ,差异无显著性 (P =0 2 5 5 ) ;不同级别子宫颈癌前病变的HPV DNA含量 ,CINⅠ为 332± 2 9,CINⅡ为 35 8±35 ,CINⅢ为 370± 31,均明显高于宫颈炎 (P =0 0 0 0 ) ,但不同级别CIN之间比较 ,差异无显著性 (P >0 0 5 ) ;SCC的HPV DNA含量为 5 93± 86 ,显著高于不同级别CIN和宫颈炎的HPV DNA含量 (P <0 0 5 ,P <0 0 1)。结论 HC Ⅱ方法是检测宫颈HPV感染的有效手段 ,HPV DNA含量随宫颈病变的严重程度而增加 ,可作为子宫颈癌的一种初筛方法。
Objective To investigate the relationship between human papillomavirus (HPV) load and cervical cancer and its precancerous lesions. Methods From December 2001 to May 2002, 90 75 married women aged 35 ~ 50 years who had a high incidence of cervical cancer in Shanxi Province were detected by the method of hybridization capture second generation (HC Ⅱ) Cervical HPV DNA content (as a means of cervical HPV load). HPV DNA-positive women, followed by colposcopy, multiple cervical biopsy and cervical canal curettage. Results Among 2,087 HPV-positive women, there were 14 0 2 cases of cervicitis (67.2%), precancerous lesions of cervix [including cervical intraepithelial neoplasia (CIN) Ⅰ-Ⅲ] 8%), cervical invasive carcinoma (SCC) 2 2 cases (11%). The HPV DNA levels of acute and chronic cervicitis were 108 ± 13 and 150 ± 11, respectively, with no significant difference (P = 0 255). The HPV DNA levels in different grades of cervical precancerous lesions, CINⅠwas 332 ± 29, CINⅡwas 35 8 ± 35, CINⅢwas 370 ± 31, which was significantly higher than that of cervicitis (P = 0.0000), but there was no significant difference between different grades of CIN (P> The HPV DNA content of SCC was 5 93 ± 86, which was significantly higher than that of HPV with different levels of CIN and cervicitis (P <0.05, P <0.01). Conclusion The method of HC Ⅱ is an effective method to detect cervical HPV infection. The content of HPV DNA increases with the severity of cervical lesions and can be used as a primary screening method for cervical cancer.