女性人乳头瘤病毒感染与宫颈鳞状上皮内病变的关系

刘一荻; 吴欢; 陈德福; 赵洪友; 曾晶; 谭一舟; 王颖; 邱海霞; 顾瑛

doi:10.3969/j.issn.2095-5227.2021.03.003

女性人乳头瘤病毒感染与宫颈鳞状上皮内病变的关系

Association between human papillomavirus infection and cervical squamous intraepithelial lesion in women

摘要

摘要:
背景宫颈癌是全世界女性第四大最常见癌症，严重威胁着女性的生命和生殖健康。宫颈癌的预防和治疗一直是我国的主要公共卫生问题之一。持续高危型宫颈人乳头瘤病毒(high-risk human papilloma virus，HR-HPV)感染可导致宫颈癌和宫颈鳞状上皮内病变(squamous intraepithelial lesion，SIL)。
目的探讨女性HR-HPV感染型别与宫颈鳞状上皮内病变的关系。
方法依托解放军总医院大数据中心，提取2009年1月- 2019年6月于解放军总医院第一医学中心接受基于基因扩增及导流杂交技术的HPV分型检测并于180 d内行宫颈组织病理活检，且组织病理学排除宫颈癌的北京地区患者资料。
结果 1)共纳入280例符合条件的患者，HPV阳性262例(93.57%)；组织病理确诊为SIL279例(99.64%)，其中高级别鳞状上皮内病变(high-grade SIL，HSIL)的患者125例(44.64%)，低级别鳞状上皮内病变(low-grade SIL，LSIL)154例(55%)。2)HSIL和LSIL的年龄分布最高组均为35～49岁。3)HSIL和LSIL中最常感染的5种HR-HPV基因依次为HPV16、HPV58、HPV52、HPV18、HPV56。4)HSIL和LSIL均以单一HPV感染为主，且单一和多重感染HPV的占比在HSIL与LSIL之间无明显差异。
结论本研究中，女性HSIL/LSIL发病的高峰年龄为35 ~ 49岁。HPV16、HPV58和HPV52是最主要的HR-HPV基因型，以上三型患者应纳入高危人群管理，防止病变进展。多重HR-HPV感染并不会增加罹患HSIL的风险。

Abstract:
Background Cervical cancer ranks the fourth most common cancers in women and greatly threatens women’s lives. The prevention and treatment of cervical cancer has been one of the major public health problems in China. Persistent infection with high-risk human papillomavirus (HR-HPV) causes cervical cancer and cervical squamous intraepithelial lesion (SIL).
Objective To investigate the relationship between HR-HPV types and SIL.
Methods With the support of Medical Big Data Center of Chinese PLA General Hospital, the data about female patients in Beijing who underwent HPV genotyping based on gene amplification and flow-through hybridization and gene chip and cervical biopsy in our hospital from January 2009 to June 2019 were screened out, with an interval of ≤ 180 days between the two examinations. The association between HPV genotyping and SIL was analyzed, and the association of age with HPV genotyping and SIL was also assessed, as well as the association of the number of HPV infection types with SIL.
Results A total of 280 female patients were eligible for this study, among whom 279 (99.64%) were diagnosed with SIL, 262 (93.57%) had HR-HPV, 125 patients (44.64%) had high-grade squamous intraepithelial lesion (HSIL), 154 patients (55%) had low-grade squamous intraepithelial lesion (LSIL). The female patients aged from 35 to 49 years had the highest incidence rate of HSIL/LSIL based on pathology. For the female patients with HSIL/LSIL, HPV16 was the most common HPV genotype, followed by HPV58, HPV52, HPV18 and HPV56. The frequency of single and multiple HPV infections was 62.86% and 30.71%, respectively, and the proportion of single/ multiple infections showed no significant different between HSIL and LSIL.
Conclusion The peak age with HSIL/LSIL is 35 to 49 years old. HPV16, HPV58 and HPV52 are the main high-risk HPV genotypes. Multiple high-risk HPV infections do not increase the risk of high-grade intraepithelial neoplasia.

HTML全文

参考文献(26)

施引文献

资源附件(0)