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目的:研究子宫颈癌及癌前病变与人乳头状瘤病毒(HPV)负荷量的关系。方法:选择2011年1月～2012年6月在该院门诊行宫颈癌前病变筛查的4 258例妇女为研究对象,采用第2代杂交捕获试验(HCⅡ)进行宫颈HPV-DNA定量检测,对HPV-DNA呈阳性的妇女进行阴道镜宫颈多点活体组织检查、宫颈管诊断性刮宫术。结果:948例HPV阳性妇女中有宫颈炎742例(78.27%),宫颈癌前病变(CIN)181例(19.09%),宫颈癌25例(2.64%)。当HPV-DNA定量>100时,宫颈癌前病变组的阳性率明显升高,当HPV-DNA定量>500时,宫颈癌组的阳性率明显升高,差异有统计学意义(P<0.05)。宫颈炎组主要分布在HPV-DNA定量<100段。宫颈癌HPV-DNA含量显著高于宫颈癌前病变患者,宫颈癌前病变HPV-DNA含量显著高于宫颈炎患者,三组HPV-DNA含量差异有统计学意义(P<0.05)。结论:宫颈HPV-DNA定量检测可作为子宫颈HPV感染的诊断依据,高危型HPV-DNA含量随病变的严重程度而增加,高危型HPV感染与宫颈癌前病变及宫颈癌病程发生关系密切。
Objective: To study the relationship between cervical cancer and precancerous lesions and human papillomavirus (HPV) load. Methods: A total of 4 258 cervical screening precancerous lesions in our hospital from January 2011 to June 2012 were selected as study subjects. The second generation hybridization capture test (HCⅡ) was used to detect HPV-DNA in the cervix. HPV-DNA-positive women colposcopic cervix multi-point biopsy, cervical canal diagnostic curettage. Results: Among the 948 HPV positive women, 742 (78.27%) had cervicitis, 181 (19.09%) had cervical precancerous lesions (CIN) and 25 (2.64%) had cervical cancer. The positive rate of cervical precancerous lesions was significantly higher when the quantity of HPV-DNA was> 100, and the positive rate of cervical cancer was significantly increased when the quantity of HPV-DNA was> 500 (P <0.05) . Cervicitis group mainly in the HPV-DNA <100 segments. The content of HPV-DNA in cervical cancer was significantly higher than that in cervical precancerous lesions. The content of HPV-DNA in cervical precancerous lesions was significantly higher than that in patients with cervicitis. There was significant difference in HPV-DNA content between the three groups (P <0.05). Conclusion: The quantitative detection of HPV-DNA in the cervix can be used as the basis for the diagnosis of cervical HPV infection. The high-risk HPV-DNA content increases with the severity of the disease. The high-risk HPV infection is closely related to the cervical precancerous lesions and the progression of cervical cancer.