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目的:探讨十堰地区妇女人乳头瘤病毒(HPV)感染在宫颈病变患者中的分布,分析HPV与宫颈癌及癌前病变的关系。方法:从石蜡包埋组织标本中提取基因组DNA,基因芯片导流杂交技术进行HPV基因分型,比较不同宫颈病变组HPV的感染率。结果:928例石蜡包埋组织中,高危型HPV感染率为42.99%(399/928),在慢性宫颈炎、宫颈上皮内瘤变(CIN)、宫颈癌中的感染率分别为21.5%(120/558)、70.17%(207/295)、96.0%(72/75),3组不同宫颈病变的感染率有差异(P<0.01)。HPV16和HPV52两型居感染的前2位,在CINⅡ/Ⅲ以上的患者中感染排在前5位的是HPV 16、33、52、58、31,其中HPV 16、33、52型感染率与宫颈病变程度有相关性(P<0.05)。单一基因型别感染、双重感染、三重以上混合感染分别占阳性患者的75.44%(301/399)、17.79%(71/399)、6.77%(27/399)。结论:高危亚型HPV感染是引起宫颈上皮内病变的主要因素,HPV16是十堰地区感染率最高的HPV亚型,仍然是宫颈癌的最大威胁。基因芯片技术特异性强,敏感性高,对早期发现宫颈癌及预后判断有重要价值。
Objective: To investigate the distribution of human papillomavirus (HPV) in women with cervical lesions in Shiyan and to analyze the relationship between HPV and cervical cancer and precancerous lesions. Methods: Genomic DNA was extracted from paraffin-embedded tissue samples and HPV genotyping was performed by flow cytometry. The HPV infection rates in different cervical lesions were compared. Results: In 928 paraffin-embedded tissues, the infection rate of high-risk HPV was 42.99% (399/928), and the infection rates in chronic cervicitis, cervical intraepithelial neoplasia (CIN) and cervical cancer were 21.5% (120 /558),70.17%(207/295),96.0%(72/75). There were differences in the infection rates among the three groups of cervical lesions (P <0.01). HPV16 and HPV52 two types of infection in the first two, in patients with CIN Ⅱ / Ⅲ infection in the top five are HPV 16,33,52,58,31, HPV 16,33,52 type infection rate and Cervical lesions have a correlation (P <0.05). Single genotype infection, double infection, triple or more mixed infections accounted for 75.44% (301/399), 17.79% (71/399), 6.77% (27/399) respectively. Conclusion: High-risk subtypes of HPV infection are the main factors leading to cervical intraepithelial lesion. HPV16 is the most prevalent HPV subtype in Shiyan area and remains the biggest threat to cervical cancer. Gene chip technology-specific, high sensitivity, early detection of cervical cancer and prognosis of great value.