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目的探讨人乳头状瘤病毒(HPV)感染患者的各HPV型别分布,及各型别HPV感染与宫颈不同程度病变的关系。方法采用核酸分子快速导流杂交基因微阵列分型检测技术,分析740例女性HPV感染者的HPV型别,同时检测宫颈病变程度。结果在740例HPV感染者中常见的21种亚型均被检出,排在前3位的亚型分别为16、58、52;高危型HPV混合低危型HPV的混合感染与单一高危型HPV感染和多种高危型HPV混合感染之间,宫颈不同程度病变差异无统计学意义,而以上几种感染类型与低危HPV感染相比,宫颈病变程度差异有统计学意义(均P<0.01),多元logistic回归分析显示,感染16型HPV(OR=3.56,P<0.01),58型HPV(OR=1.29,P<0.05)使宫颈癌患病风险大大增加;把宫颈上皮内瘤变分为低等级(CINⅠ)和高等级(CINⅡ、CINⅢ)病变,以不同程度的宫颈上皮内瘤变作为分析因素进行二元logistic回归,显示6型HPV(OR=6.99,P<0.01)、11型HPV(OR=5.92,P<0.01)感染将使感染者宫颈上皮内瘤变CINⅠ的风险大大升高。结论相对于低危型HPV,感染高危型HPV是宫颈病变加重的重要因素;高危型的16、18型HPV感染引起宫颈癌的患病风险增加,低危型的6型、11型HPV感染则更易引低级别的宫颈上皮内瘤变的发生。
Objective To investigate the distribution of HPV types in patients with human papillomavirus (HPV) infection and the relationship between different types of HPV infection and different degrees of cervical lesions. Methods The genotyping of nucleic acid molecules by rapid flow-through hybridization microarray was used to analyze the HPV types of 740 women with HPV infection and to detect the degree of cervical lesions. Results A total of 21 subtypes were detected in 740 cases of HPV infection. The top three subtypes were detected as 16, 58 and 52 respectively. The mixed infection of high-risk HPV and low-risk HPV was associated with a single high-risk type HPV infection and a variety of high-risk HPV mixed infection, cervical lesions of varying degrees was no significant difference, while the above types of infection compared with low-risk HPV infection, cervical lesions were significantly different (all P <0.01 ), Multivariate logistic regression analysis showed that HPV 16 (OR = 3.56, P <0.01) and HPV58 (OR = 1.29, P <0.05) significantly increased the risk of cervical cancer. Cervical intraepithelial neoplasia (CINⅠ) and high grade (CINⅡ, CINⅢ) lesions, with different degrees of cervical intraepithelial neoplasia as a factor for analysis of binary logistic regression showed that type 6 HPV (OR = 6.99, P 0.01) Infection with HPV (OR = 5.92, P <0.01) significantly increased the risk of cervical intraepithelial neoplasia in women with CIN I. Conclusions Compared with low-risk HPV, high-risk HPV infection is an important factor for cervical lesions. High-risk HPV types 16 and 18 cause an increased risk of cervical cancer. Low-risk HPV types 6 and 11 More easily lead to lower levels of cervical intraepithelial neoplasia.