广西柳州18～45岁女性人乳头瘤病毒16/18型中和抗体流行率及其与宫颈病变相关性的研究

阐明广西柳州地区自然人群中18~45岁女性人乳头瘤病毒(HPV)16/18型中和抗体和DNA流行情况,并探讨其与子宫颈癌癌前病变的相关性。2013年3月至7月在柳州市招募2 300名18~45岁女性,采集血清以假病毒中和试验(PBNA)法检测HPV16/18型中和抗体,同时采集宫颈脱落细胞进行液基细胞学诊断和HPV DNA检测,对细胞学异常者进行阴道镜检查,并对采集的组织学标本进行病理诊断。采用趋势性χ2检验分析不同年龄段HPV DNA阳性率及HPV中和抗体阳性率的差异,Logistic回归分析筛选宫颈癌前病变的影响因素。广西柳州地区18~45岁女性自然人群中,HPV16DNA或中和抗体阳性364例(15.8%,95%CI:14.4,17.4),HPV18DNA或中和抗体阳性164例(7.1%,95%CI:6.1,8.3)。CIN3在不同年龄组的卡方趋势检验有统计学意义(P=0.005),HPV16和HPV18型DNA阳性是CIN1+(宫颈上皮内瘤变1级及以上)、CIN2+(宫颈上皮内瘤变2级及以上)的主要危险因素,而自然感染产生的中和抗体与癌前病变未发现统计学相关性。HPV16/18型感染是宫颈癌癌前病变的主要危险因素,并未发现自然感染产生的中和抗体与其相关,表明接种疫苗仍是18~45岁女性预防HPV感染及癌前病变的主要方式。     

HPV-DNA 和TCT 检测在宫颈癌前病变筛查中的诊断价值

目的:探讨乳头瘤病毒定性检测( HPV- DNA)与液基薄层细胞学检查技术(TCT)在宫颈癌前病变中的诊断价值.方法:分别采用HPV- DNA及TCT法检测1536例患者,对TCT阳性、HPV- DNA阳性病例者进行阴道镜下活检.结果:随着病理诊断级别的升高,高危型HPV感染率上升,而低危型HPV感染多见于轻度不典型增生(CINⅠ)及其以下病变,HPV混合感染在各组间未见明显趋势.HPV-DNA检测与宫颈活检的符合率为66.78％.随着病理级别的升高,不典型鳞状细胞(ASCUS)组的感染率呈降低趋势,鳞状上皮内低度病变(LSIL)组感染率亦呈下降趋势,而鳞状上皮内高度病变(HSIL)组和鳞癌(SCC)组感染率均呈上升趋势,TCT检测与组织学诊断的符合率为66.67％,与HPV-DNA检查比较,差异无统计学意义(x=0.001,P＞0.05).结论:HPV-DNA、TCT及宫颈活检三者检测相结合,能明显提高诊断的正确性.     

用光敏生物素标记探针检测宫颈癌、尖锐湿疣及假性湿疣组织中HPV DNA

人乳头瘤病毒(简称HPV)能引起人皮肤及粘膜的多种良恶性肿瘤,特别多见于女性生殖系统如宫颈癌、尖锐湿疣和假性湿疣。但由于HPV尚不能在体外细胞培养中增殖,因此目前对其研究主要用核酸杂交和PCR方法,检测HPV DNA。本文采用光敏生物素标记HPV16、HPV18 DNA探针,分别对宫颈癌组织进行斑点杂交,检测宫颈癌组织中HPV16、18DNA并以正常宫颈组织做对照。以同样方法用HPV6b DNA探针检测尖锐湿疣及假性湿疣组织中HPV6b DNA。结果如下:18例宫颈癌组织中仅有1例与HPV16 DNA探针杂交阳性(5.7%);10例与HPV18杂交刚性(55.6%);4例为HPV16+18混合杂交阳性(22.2%)。12例尖锐湿疣组织中8例与HPV6b DNA杂交阳性(66.7%);12例假性湿疣组织中有6例与HPV6b探针杂交阳性(50%)。10例正常宫颈组织对照均为阴性。     

HPV病毒感染与宫颈炎症及宫颈癌之间的关系及意义分析

目的研究人乳头瘤病毒(HPV)在宫颈炎症、宫颈癌前病变及宫颈癌中的水平及临床意义。方法分别选取宫颈炎症278例、宫颈癌前病变174例、宫颈腺癌82例、宫颈鳞癌183例患者,并以218例宫颈无病变的病例作为对照,所有患者均行薄层液基细胞学(TCT)检查及阴道镜下病理活检,检测各组患者间HPV阳性水平并对统计结果加以分析。结果 218例宫颈无病变病例中高危性HPV阳性率为9.6%(21/218),其余717例宫颈出现病变的患者中高危型HPV筛查结果阳性例数为405例,阳性检出率56.5%,且随着宫颈病变严重程度的加重,高危型HPV检出率逐渐升高(P0.01),但是宫颈腺癌和宫颈鳞癌组的高危型HPV阳性率比较差异无统计学意义(P0.05)。结论 HPV是宫颈癌前病变及宫颈癌的主要致病因素,对宫颈炎症、宫颈癌前病变及宫颈癌患者行HPV检测对于患者早日确诊及早日治疗具有重要意义。     

食管鳞癌人乳头状瘤病毒感染的原位杂交检测和观察

目的 :检测食管鳞癌中人乳头状瘤病毒 (HPV)的感染情况 ,探讨 HPV与食管癌发病的关系。方法 :用原位杂交技术及免疫组化方法对 33例食管鳞癌手术切除标本进行 HPV检测。结果 :用原位杂交方法检测食管鳞癌中 HPV DNA检出率为 4 5 .5 % (15 / 33)。HPV DNA阳性与食管鳞癌肿瘤细胞的分化程度无关 (P>0 .0 5 )。HPV衣壳蛋白的免疫组化检测均为阴性。结论 :HPV感染可能是引起食管上皮癌变的原因之一 ,与食管鳞癌的发生有关。即使在存在 HPV DNA的病例中 ,HPV衣壳蛋白亦可以不表达     

HPV和HCMV在慢性宫颈炎病人中的分布及相关性研究

本文采用DNA-DNA分子杂交技术对病理组织学确诊的87例慢性宫颈炎患者和25例健康宫颈的宫颈活检组织DNA进行了HPV 6、11、16、18型DNA及HCMV HindⅢE片段检测。结果表明,对照宫颈检出率全部为0,慢性宫颈炎检出率HPV 6为16％,HPVll为12.6％,HPV16为11.5％,HPVl8为5％,总的HPV DNA相关序列为29.0％,HCMV为12.64％。经显著性检验,HPV DNA相关序列检出率在慢性宫颈炎与对照组间具显著性差异,HPV DNA相关序列阳性者患慢性宫颈炎的危险性为HPV DNA相关序列阴性者20.81的倍。本实验结果还表明HCMV阳性患者中72.7％的病人同时有HPV感染,提示HCMV感染与HPV感染有关。     

采用PCR-测序法对北京地区325例妇女宫颈脱落细胞样品中人乳头瘤病毒进行检测和基因分型

为了探讨PCR-测序法在宫颈脱落细胞样品中人乳头瘤病毒 (Human papillomavirus, HPV) 临床检测中的应用价值,采用HPV通用引物PGMY09/11针对HPV L1区基因序列进行PCR扩增,并通过DNA测序法对HPV进行基因分型。对于混合感染样品,利用HPV型别特异性引物PCR的方法进行基因分型。325例临床样品中,228例为HPV阳性,其中66例为混合感染。共发现27种不同的HPV型别,其中HPV 16比例最多,其次是HPV 58和52。高危型HPV检出率随病变程度加重显著性增加     

宫颈HPV16持续感染阶段宫颈P16和Ki67的表达及其与宫颈癌变的关系

目的:探讨宫颈人乳头状瘤病毒(HPV)16持续感染阶段宫颈P16和Ki67的表达及其与宫颈癌变的相关性。方法:采用P16/Ki67免疫组化双染法检测102例HPV16持续感染者、136例非持续感染者宫颈组织P16、Ki67蛋白的表达,并根据免疫组化结果分组为双染阳性组、双染阴性组。所有患者随访观察2年,比较两组患者的结局及宫颈癌前病变的发生率。结果:P16、Ki67及P16/Ki67双染的阳性率分别为40.3%、44.5%及34.0%,HPV16持续感染患者P16、Ki67及P16/Ki67双染的阳性率均显著高于非持续感染患者(P0.05)。HPV16持续感染患者的P16、Ki67蛋白表达呈显著正相关(P0.05)。HPV16持续感染患者中,双染阳性组的病情持续和进展比例明显高于双染阴性组,也明显高于HPV16非持续感染(双染阴性组、双染阳性组)患者(P0.05)。HPV16持续感染患者中,双染阳性组进展为HSIL及以上病变发生率为32.5%(13/40),显著高于双染阴性组6.5%(P0.05)。结论:P16,Ki67双染阳性在HPV16持续感染阶段与宫颈上皮内病变疾病进展成正相关,对HPV16持续感染进展为宫颈高度病变有预警价值,可作为HPV16阳性早期治疗的敏感指标。     

HLA-Ⅰ表达与维吾尔族妇女宫颈癌前病变及HPV16感染的关系研究

目的:现察人白细胞相关抗原Ⅰ(human leukocyte antigen class Ⅰ, HLA-Ⅰ)表达与维吾尔族妇女宫颈癌前病变进程及高危型HPV16的关系.方法:收集维吾尔族妇女宫颈炎、宫颈内上皮瘤样病(cervical intraepithelial neoplasia, CIN)和宫颈鳞癌患者的石蜡包埋组织标本共148例,提取组织DNA,应用PCR的方法检测HPV阳性及HPV16型别;同时采用免疫组织化学SP法检测HLA-Ⅰ蛋白表达水平.结果:(1)在维吾尔族妇女中HLA-Ⅰ抗原在宫颈炎、CIN Ⅰ-Ⅱ、CIN Ⅲ、SCC组中阳性表达逐渐减少,差异有统计学意义(P<0.001).(2)HLA-Ⅰ的阳性表达下降趋势与宫颈癌临床分期、组织分化程度和淋巴结转移密切相关.(3)HPV在宫颈炎、CIN Ⅰ-Ⅱ、CIN Ⅲ、宫颈癌中的感染率分别为13%、46%、82%、95%,差异有统计学(P<0.001).(4)HPV16在宫颈炎、CIN Ⅰ-Ⅱ、CINⅢ、宫颈癌中的感染率分别为4%、30%、68%、85%,差异有统计学(P<0.001).(5)在HPV 16阳性标本中,存在HLA-Ⅰ表达缺失的占71%(58/82),HPV16感染与HLA-Ⅰ表达呈负相关(r=-0.625,P<0.001).结论:(1)HLA-Ⅰ表达缺陷可能是宫颈病变进展的重要标志,对宫颈癌的预测预警提供依据.(2)HPV16感染在宫颈病变的发展过程中起到了极大的促进作用,是一个很强的致癌因素.(3)HPV16感染与HLA-Ⅰ表达之间的关系对揭示宫颈癌发病机制提供了客观依据.     

HPV分型及其高危亚型与宫颈病变的关系

目的研究HPV分型及其高危亚型与宫颈病变程度的关系。方法采用HPV基因分型技术对2014年7月至2015年8月在广州中医药大学第一附属医院妇科门诊就诊和体检的3 142例患者进行HPV分型检测,其中327例患者进行宫颈病理检查,分析高危型HPV感染与宫颈病变程度的关系。结果 3 142例受检对象中,21种HPV型别均被检测出,阳性检出者共969例,总检出率为30.80%,其中高危型741例,检出率为23.58%。随着宫颈病变级别的升高,高危型HPV阳性率也相应升高(P0.05),HPV16型感染阳性者宫颈癌发生率最高(P0.05)。高危型HPV阳性者中单一感染和多重感染与宫颈病变程度无关(P0.05)。结论高危型HPV亚型检测在宫颈病变预防和诊治中具有重要意义。     

Using the number of koilocytes to predict HIV serostatus in women with HPV-associated SIL

OBJECTIVE: To investigate the relationship between specific cytopathologic changes, koilocyte counts and human papillomavirus (HPV) types in HIV-positive and -negative women. STUDY DESIGN: A cohort of 459 women (266 HIV+ and 193 HIV-), were examined in a multicentric study (Early Diagnosis of Neoplasia in AIDS) involving 14 gynecologic centers. Altogether, 97 women had cervical smears consistent with squamous intraepithelial lesions (SIL). Koilocytes were found in 60/97 SIL slides, subjected to quantitative counting in 30 predetermined fields. HPV genotype was determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. RESULTS: SIL lesions were four times more frequent (29%) in HIV-positive women than in HIV-negative women (10%) (odds ratio = 3.80). HPV DNA was equally frequent in both groups. There was a strong association between the number of koilocytes and HIV serostatus in both high grade and low grade SIL diagnoses. The presence of eight or more koilocytes had a specificity of 93% and sensitivity of 76% toward the diagnosis of HIV-positive status. No HIV-negative woman had a count > 8 koilocytes. No association was shown between koilocyte count and HPV genotype. CONCLUSION: An elevated number of koilocytes could suggest the possibility of HIV infection. Pap smear examination might give the first clue to HIV positivity in otherwise-unsuspected cases.     

Cervical smears in assessment of the natural history of human papillomavirus infections in prospectively followed women

The value of cervical (Papanicolaou) smears in monitoring the natural history of cervical human papillomavirus (HPV) infections was assessed in a series of 513 women prospectively followed since 1981. On each clinic visit, the patients were subjected to colposcopy accompanied by cervical smears and/or punch biopsies. The latter were analyzed by light microscopy for concomitant cervical intraepithelial neoplasia (CIN) and by transmission electron microscopy (TEM) for HPV particles as well as for HPV structural proteins. The stromal immunocompetent cell (ICC) infiltrates were phenotypically characterized using monoclonal antibodies for T-cell subsets, NK and K cells and Langerhans cells. HPV DNA typing was accomplished by Southern blot, spot and in situ hybridization using probes for HPV 6, 11, 16, 18 and 31. Lesions showing only changes consistent with HPV infection (HPV-NCIN) were associated with less severe atypia in cervical smears than were lesions with coexistent CIN (HPV-CIN). Normal smears were observed, however, in 24.7% of the cases with HPV-NCIN lesions, in 11.5% of cases with HPV-CIN I lesions but only exceptionally in cases with HPV-CIN II and III lesions (2.2% and 3.3%). The percentages of the different ICC phenotypes did not correlate with the atypia in cervical smears, but there was a shift towards the lower values of the T-helper/T-suppressor (OKT4+/OKT8+) cell ratio in parallel with increasing atypia. The possibility of latent HPV infection was suggested by the detection of viral particles, HPV antigens and HPV DNA in lesions shedding normal cells in the smears. The high-risk HPV types 16 and 18 were associated with the highest frequency of severely atypical cells; in the majority of cases, the low-risk types HPV 6 and 11 presented with less severe atypia. The first cervical smear seems to be of value as a predictor of the natural history of HPV lesions, as indicated by the fact that regression was inversely and progression directly related to initial cellular atypia. The present results confirm the intimate association between HPV infections and CIN. Although the biologic potential of the HPV infections seems to be dependent on multiple factors, routine cervical smears, because of their potential value in monitoring the natural history of this infection, should constitute an important means in the prospective follow-up of these patients.     

宫颈癌病变组织人乳头瘤病毒感染率的免疫细胞化学与DNA杂交的比较观察

近年来人乳头瘤病毒（ＨＰＶ）被认为与宫颈癌的发生有密切关系。该实验报道了用分子杂交技术（在严格条件下）检测了宫颈活检组织：慢性宫颈炎、宫颈上皮内瘤（ＣＩＮ）、宫颈癌和宫颈正常组织中１６型乳头瘤病毒（ＨＰＶ－１６）ＤＮＡ的阳性率,并将其与用免疫细胞化学方法（ＰＡＰ）所得结果进行了比较。结果显示１３％（２／１５）的慢性宫颈炎、１７％（２／１２）的ＣＩＮ、５６％（５１／９１）的宫颈癌含有ＨＰＶ－１６ＤＮＡ,而正常组织为阴性;ＨＰＶ属抗原仅见于３５％（６／１７）的ＣＩＮ,其他受检组织均为阴性。结果提示用ＰＡＰ法检查ＨＰＶ－１６的抗原,所得阳性率不及ＤＮＡ杂交所得阳性率高;但它作为一种简便、快速的方法用于福尔马林固定、石腊切片材料,显示ＨＰＶ属抗原,借以筛选多种不同型的ＨＰＶ对ＣＩＮ或其他组织中ＨＰＶ的增殖性感染有一定的价值。     

宫颈癌患者人乳头瘤病毒(HPV)主要型别及其感染研究

本文探讨了江西省和广东省宫颈癌患者人乳头瘤病毒(Human papillomavirus,HPV)感染及其型别分布,分析了高危型HPV对各种宫颈病变的感染情况,为宫颈癌的早期发现和临床诊治提供科学依据。首先采用细胞学、HPV DNA检测(第二代杂交捕获法,HC2)、电子阴道镜和宫颈化学着色方法筛查宫颈癌患者,经病理镜检确诊,然后用GP PCR-SBT法对宫颈癌患者进行HPV基因分型。江西省溪口镇、古市镇及修水县城宫颈癌癌前病变发生率为5．7‰。HC2方法发现宫颈癌患者13种高危型HPV DNA阳性率为89．9％,宫颈上皮内瘤样病变的为84．8％,对照组为24．5％。采用GP PCR-SBT方法进行基因分型发现,江西省宫颈癌患者存在HPV16、58、31、33、18、66、6、11、56和81十种型别,其中HPV81型在国内外鲜有报道。据此提出生殖道高危型HPV感染是妇女宫颈癌发病的重要因素。并发现江西省宫颈癌高发区妇女高危型HPV感染率为24．5％。建立了HPV基因分型的方法,对HPV致宫颈病变的分子机制进行了分析。     

Human papillomavirus DNA detection in Papanicolaou-stained cervical smears with a nonradioactive, in situ hybridization assay.

Archived Papanicolaou-stained cervical smears from women with different cervical pathologies were processed for human papillomavirus (HPV) DNA detection and typing with an in situ hybridization (ISH) assay that employed commercial biotinylated HPV DNA probes. Two HPV DNA probes were utilized: one included HPV genotypes 6/11 and the other, 16/18. The method yielded positive results for HPV DNA 6/11 in 5 cases with condylomata acuminata (100%) and in 2 of 47 with flat warty lesions (4.2%), whereas HPV DNA 16/18 was detected in 29/47 of the latter group (61.7%). In cases with cervical intraepithelial III or invasive squamous cell carcinoma the yield was lower: positive results for HPV DNA 16/18 were obtained in only one of the five cases with one or the other cervical pathology (20%). An analysis of the results showed that the sensitivity of the assay correlated with evidence in the Papanicolaou specimens of pathognomonic cell injury from HPV infection. In the presence of such cytologic features, HPV DNA typing was possible in 37/52 cases (65.4%). In view of the modest difficulty and relatively quick execution of the nonradioactive ISH assay, the authors believe that Papanicolaou cervical smears with cytologic changes of HPV infection could be processed by this method in order to acquire information on the HPV type or types involved in the cervical infection.     

Prevalence of human papillomavirus among Croatian women attending regular gynecological visit

Human papillomavirus (HPV) infection has been identified as major risk factor for cervical intraepithelial neoplasia (CIN) and invasive cervical cancer. About 40 HPV viral types are commonly found in the genital tract. Most HPV infections resolve spontaneously, while persistent infection with oncogenic types, namely HPV 16 and 18 is necessary for CIN to occur and progress to cancer. Cervical screening is presently based on the Pap smear that is designed to diagnose precancerous lesions and cervical cancer The aim of this study was to investigate the prevalence of HPV DNA and to determine HPV types distribution among 361 women attending regular gynecological visit. There were 205 women (29+/-8 years old) without determined abnormal cervical lesions and 156 women (34+/-15 years old) with abnormal Pap smear; low grade squamous intraepitehelial lesions (LSIL, n=69), high grade squamous intraepithelial lesions (HSIL, n=72) and atypical squamous cells of undetermined significance (ASCUS, n=15). HPV DNA detection and genotyping was performed by Hybrid Capture 2 assay and additionally by consensus and type-specific primers directed PCR. The overall prevalence of high-risk HPV (hrHPV) in women with abnormal Pap smears was 67.9% (106/156), of which in ASCUS 33.4% (5/15), LSIL 62.3% (43/69) and HSIL 80.6% (58/72). In HPV positive specimens, HPV 16 was found as predominant type in 60.4% cases, followed by HPV 31 (8.5%), HPV 33 (6.6%) and HPV 18 (3.7%). In the group of women without obvious cervical changes the overall hrHPV prevalence was 35.6% with HPV 16 found in 43.8% cases, followed by HPV 31 (17.8%), HPV33 (9.5%) and HPV18 (6.8%). In both study groups, women with and without cervical lesions, the prevalence of HPVof indeterminate type was 14.2% and 13.7%, respectively. Our results indicate that cervical intraepithelial lesions are largely associated with HPV type 16, followed by HPV types 31, 33, 18 and HPV of indeterminate type. Although there is a significant difference in hrHPV DNA prevalence among two groups, no significant differences between particular hrHPV types distribution were observed.     

人乳头瘤病毒与宫颈癌前病变的相关性研究

目的：探讨人乳头瘤病毒感染与宫颈癌前病变两者之间的相关性。方法：选择2009年11月～2011年12月来我院就诊的220例宫颈病变患者为研究对象,将患者分成4组,即炎症组、CINl组、CIN2组和CIN3组,各组进行人乳头瘤病毒检出率及病毒载量的比较。结果：炎症组、CINl、CIN2和CIN34组人乳头瘤病毒的检出率分别为67．2％、80％、87．3％和91．4％且4组之间比较差异有显著统计学意义（P〈O．001）。炎症组HPV感染的阳性率与CIN组比较显著降低（P〈0．005）,宫颈癌前病变各组HPV感染呈阳性的病毒载量差异有统计学意义（P〈0．05）。结论：宫颈癌前病变的严重程度和感染高危型HPV病毒载量呈正相关,随着感染高危型HPV病毒载量越高,宫颈癌前病变的程度越严重。     

Viral load of HPV 16/18 in esophageal squamous cell carcinoma in three ethnic groups living in Xinjiang Autonomous Region, China

To investigate the viral load of human papillomavirus (HPV) in esophageal squamous cell carcinoma (ESCC) patients from three ethnic groups in Xinjiang. Using Gp5+/Gp6+ consensus primers, the prevalence of HPV DNA was examined in 253 paraffin-embedded ESCC samples. The presence and viral load of HPV 16 and HPV 18 were detected in Kazakhs, Uygurs and Hans using type-specific primers by quantitative real-time PCR (qRT-PCR). Among the 253 ESCC samples, 52 cases were positive for HPV DNA, all the 52 positive cases displayed HPV 16 infection, and six of the 52 cases were co-infected by HPV 16 and 18. HPV 16-positive rate and viral load were higher in lesions, and was inversely correlated with differentiation grades. However, there was no statistic significance among different differentiation grades. Also, there were no significant difference between detection rates of HPV types, viral load and age, gender, ethnic group, and lymph node metastasis. HPV 16 and HPV 18 genotypes could simultaneously be detected in ESCC specimens in three main ethnic groups in Xinjiang. The viral load of HPV 16 is higher in the ESCC lesions, and is inversely correlated with the differentiation grades. These observations reinforce the suggestion that HPV infection may involved in ESCC carcinogenesis; however, high prevalence or viral load of HPV infection does not seem to be related with high incidence of ESCC in Kazakhs, which may be the one element among the multiple risk factors contributing to ESCC.     

Good agreements between self and clinician-collected specimens for the detection of human papillomavirus in Brazilian patients

Women infected with human papillomavirus (HPV) are at a higher risk of developing cervical lesions. In the current study, self and clinician-collected vaginal and cervical samples from women were processed to detect HPV DNA using polymerase chain reaction (PCR) with PGMY09/11 primers. HPV genotypes were determined using type-specific PCR. HPV DNA detection showed good concordance between self and clinician-collected samples (84.6%; kappa = 0.72). HPV infection was found in 30% women and genotyping was more concordant among high-risk HPV (HR-HPV) than low-risk HPV (HR-HPV). HPV16 was the most frequently detected among the HR-HPV types. LR-HPV was detected at a higher frequency in self-collected; however, HR-HPV types were more frequently identified in clinician-collected samples than in self-collected samples. HPV infections of multiple types were detected in 20.5% of clinician-collected samples and 15.5% of self-collected samples. In this study, we demonstrated that the HPV DNA detection rate in self-collected samples has good agreement with that of clinician-collected samples. Self-collected sampling, as a primary prevention strategy in countries with few resources, could be effective for identifying cases of HR-HPV, being more acceptable. The use of this method would enhance the coverage of screening programs for cervical cancer.     

1235例妇科门诊患者高危型HPV感染状况及亚型分布调查研究

目的了解本地区妇科门诊患者宫颈高危型HPV感染状况及亚型分布,为今后的宫颈癌前病变、宫颈癌防治提供临床依据。方法采用基因芯片技术对1 235例妇科门诊患者进行HPV筛查,筛查出的阳性患者应用流式荧光杂交法进行高危型HPV亚型检测,分析比较宫颈炎、宫颈鳞癌及宫颈腺癌患者高危型HPV感染情况及亚型分布差异。结果六安市金安区妇幼保健院妇科门诊患者HPV感染率高达60%,其中高危型HPV感染率为43. 2%,主要以HPV16、HPV18为主;低危型HPV感染率为30.0%,主要以HPV11为主;单一感染阳性率为34. 1%,而混合型感染高达65. 9%,且两者均以HPV16型和HPV18型为主。宫颈炎患者HPV16型、HPV18型及HPV16 ＋ HPV18型的检出率明显低于宫颈鳞癌和宫颈腺癌患者,其中宫颈腺癌患者HPV16 ＋ HPV18型混合感染率最高。结论妇科门诊患者HPV感染率较高,宫颈癌患者HPV16及18型检出率显著高于宫颈炎患者,加强HPV高危基因型的监测有助于预警宫颈癌尤其是宫颈腺癌的发生。