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目的分析女性尖锐湿疣(CA)患者人乳头瘤病毒(HPV)的感染情况及基因分型,探讨HPV基因型与CA预后的关系。方法临床确诊女性CA初发患者(CA组)230例,采用导流杂交基因芯片技术(HybriMax)进行HPVDNA及基因分型检测。HPV-DNA阳性患者根据HPV基因型分为高危型、低危型和混合型3组,另选健康女性作为对照,分析HPV-DNA阳性CA患者治疗前后外周血T淋巴细胞亚群变化并与健康人进行比较;观察不同HPV基因型CA患者治疗后1、3、6个月的复发情况。结果 CA患者HPV-DNA阳性率为95.22%(219/230)。HPV-DNA阳性标本中共检出21种HPV基因型,其中HPV16(7.83%)和HPV6(29.57%)分别在高危型和低危型HPV中阳性率高。治疗前不同HPV基因型CA患者的CD_3~+、CD_4~+T淋巴细胞百分比及CD_4~+/CD8+比值均显著低于健康对照组(P<0.05),CD8+T淋巴细胞百分比显著高于健康对照组(P<0.05);治疗后不同HPV基因型CA患者的CD_3~+、CD_4~+T淋巴细胞百分比及CD_4~+/CD8+比值均较治疗前显著升高(P<0.05),CD8+T淋巴细胞百分比显著降低(P<0.05);治疗前后各HPV基因型组间T淋巴细胞亚群百分率差异无统计学意义(P>0.05)。高危型患者治疗后3个月和6个月复发率分别为12.17%和15.65%,与低危型组的4.78%、6.52%和混合型组的5.56%、8.26%比较差异有统计学意义(P<0.05)。结论女性CA患者HPV感染以HPV6、HPV11及HPV16 3种基因型为主,高危型和低危型HPV可单一感染也可混合感染。CA患者细胞免疫功能失调与HPV基因分型无关,但高危型HPV感染患者治疗后复发率更高。
Objective To analyze the infection status and genotyping of human papillomavirus (HPV) in female genital warts (CA) and to explore the relationship between HPV genotypes and the prognosis of CA. Methods 230 newly diagnosed female patients (CA group) were enrolled in this study. HPVDNA and genotyping were detected by flow cytometry (HybriMax). HPV-DNA positive patients were divided into high risk, low risk and mixed type according to HPV genotype. Three healthy women were selected as control. The changes of T lymphocyte subsets in peripheral blood before and after treatment of HPV-DNA positive CA patients were analyzed and compared with healthy People were compared; observed different HPV genotype CA patients 1,3,6 months after treatment of recurrence. Results The positive rate of HPV-DNA in CA patients was 95.22% (219/230). A total of 21 HPV genotypes were detected in HPV-DNA positive samples, of which HPV16 (7.83%) and HPV6 (29.57%) were positive in high-risk and low-risk HPV respectively. The percentage of CD_3 ~ +, CD_4 ~ + T lymphocytes and CD_4 ~ + / CD8 + in patients with different HPV genotypes before treatment were significantly lower than those in healthy controls (P <0.05), and the percentage of CD8 + T lymphocytes was significantly higher than that of healthy controls (P <0.05). After treatment, the percentage of CD_3 ~ + and CD_4 ~ + T lymphocytes and the ratio of CD_4 ~ + / CD8 in CA patients with different HPV genotypes were significantly higher than those before treatment (P < (P <0.05). There was no significant difference in the percentage of T lymphocyte subsets between HPV genotype groups before and after treatment (P> 0.05). The recurrence rates of high-risk patients at 3 months and 6 months after treatment were 12.17% and 15.65%, respectively, which were significantly different from those of 4.78% and 6.52% in low-risk group and 5.56% and 8.26% in mixed-type group P <0.05). Conclusion HPV infection in female patients with CA HPV6, HPV11 and HPV16 three genotypes mainly high-risk and low-risk HPV can be single infection can also be mixed infection. Cellular immune dysfunction in CA patients has nothing to do with the genotyping of HPV, but patients with high-risk HPV infection have a higher relapse rate after treatment.