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。

Study the subtypes distribution and high-risk to HPV infection of 1235 cases gynecological outpatients

Objective To investigate the subtypes distribution and high-risk to HPV infection of gynecological outpatients in theregion, provide theoretical basis of preventing and treating uterine cervical cancer precancerous lesions and cervical cancer. Methods1 235 samples were detected for HPY genotype by using DNA hybridization technique,and we used flow fluorescence hybridization methodfor detection of high-risk HPV subtypes,and analyzed the high-risk to HPV infection and subtypes difference amongst the cervicitis,cervical squamous cell carcinoma and cervix adenocarcinoma patients. Results The rate of HPV infection in the gynecology outpatients in ourhospital was up to 60% . The rate of high-risk HPV infection was 43. 2%,mainly containing HPV 16 and HPV18. The rate of low-riskHPV infection was 30. 0%,mainly included HPV 11. The positive rate of single infections was 34. 1%,while the mixed infection was upto 65. 9%,mainly included both of HPV 16 and HPV 18 coinfection. The detection rates of HPV16, HPV18 type and HPV 16 4- HPV18among cervicitis patients were significantly lower than patients with cervical squamous cell carcinoma and adenocarcinoma. In addition,the infection rate of HPVI6 ＋ HPV18 in cervical adenocarcinoma patients was the highest. Conclusion The HPV infection rate of gynecology outpatients was higher. The detection rate of HPV 16 and 18 in cervical cancer patients was significantly higher than in patientswith cervicitis. Strengthen the monitoring of high-risk HPV genotypes could contribute to early warning of cervical cancer, especially cervical adenocarcinoma.