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目的:探讨不同亚型人乳头瘤病毒(HPV)感染与宫颈病变的关系。方法 2009年2月至2010年2月间对在新疆医科大学妇科门诊就诊及住院的发现宫颈异常(宫颈糜烂、肥大、接触性出血、溃疡及乳头样增生等)的患者及少数无临床症状和体征而要求体检的患者,经细胞学筛查为异常并经病理组织学证实的637例宫颈病变(包括宫颈炎446例、CINⅠ66例、CINⅡ59例、CINⅢ41例及ICC25例)进行HPV分型检测,并比较不同宫颈病变类型组与HPV多重感染的比例。结果①HPV总阳性率45.68%(291/637),HPV感染率随着宫颈病变级别的增加逐渐5上升(P<0.01),HPV感染在不同年龄组差异有高度显著性(P<0.01),30～49岁系高发年龄。②检出20种HPV亚型,其中高危型13种,低危型4种,中国人常见型3种,随宫颈病变程度的增加HPV亚型分布有所变化,宫颈炎组以HPV16、58、52、68、66为常见亚型,低度病变组(CINⅠ)以HPV16、53、58、33、52为常见类型,而高度病变组(CINⅡ～Ⅲ)以高危型HPV16、58、33、31、52型为最常见,25例浸润癌检出5种高危亚型HPV,分别是HPV16、58、18、31、33型。HPV16亚型随宫颈病变级别加重感染率呈上升趋势(P<0.01)。③多重感染的比例为18.21%,最常见类型为HPV16、52的二重感染,HPV多重感染的比例随宫颈病变级别增加无明显变化,差异无显著性(P>0.05)。结论感染率最高的高危型HPV16、58、52、31、68、18是主要致病基因型,尤其是HPV16型与宫颈病变程度有关,高危型HPV持续感染及多重感染是导致宫颈癌变的主要原因之一,但HPV多重感染不增加宫颈病变的严重程度。
Objective: To investigate the relationship between different subtypes of human papillomavirus (HPV) infection and cervical lesions. Methods From February 2009 to February 2010, patients with cervical abnormalities (cervical erosion, hypertrophy, contact bleeding, ulceration, papillary hyperplasia, etc.) Were found in gynecological outpatient clinics and inpatients in Xinjiang Medical University, and a few patients without clinical symptoms and Signs and requirements of the physical examination, cytology screening for abnormal and pathologically confirmed 637 cases of cervical lesions (including 446 cases of cervicitis, CINⅠ66 cases, CINⅡ59 cases, CINⅢ41 cases and ICC25 cases) for HPV typing detection, And compare the different types of cervical lesions and HPV multiple infection ratio. Results ① The positive rate of HPV infection was 45.68% (291/637). HPV infection rate gradually increased with the increase of cervical lesions (P <0.01). The HPV infection in different age groups was highly significant (P <0.01), 30 ~ 49 years old high incidence of age. ②Twenty kinds of HPV subtypes were detected, of which 13 were high risk type, 4 were low risk type and 3 were Chinese common type. The distribution of HPV subtypes was changed with the increase of cervical lesions. Cervicitis group was treated with HPV16,58, 52,68,66 common subtypes, low lesions group (CINⅠ) with HPV16,53,58,33,52 as the common type, while the highly diseased group (CINⅡ ~ Ⅲ) with high-risk HPV16,58,33,31 , Type 52 is the most common, 25 cases of invasive carcinoma detected five kinds of high-risk subtype of HPV, respectively, HPV16,58,18,31,33 type. HPV16 subtype increased with the severity of cervical lesions increased (P <0.01). ③ The rate of multiple infection was 18.21%. The most common type was double infection of HPV16,52. The proportion of multiple HPV infection did not change with the increase of cervical lesions. There was no significant difference (P> 0.05). Conclusion The highest infection rate of high-risk HPV16,58,52,31,68,18 is the main pathogenic genotype, especially HPV16 type and cervical lesions, persistent high-risk HPV infection and multiple infections are the main causes of cervical cancer One, but multiple HPV infection does not increase the severity of cervical lesions.