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。

Major Genotypes of Human Papillomavirus and Its Infection Prevalence in Women with Cervical Cancer

To investigate the infection and genotype distribution of human papillomavirus (HPV) in patients with cervical cancer in Jiangxi and Guangdong Provinces,the prevalence of high-risk HPV infection of various cervical lesions was analyzed to provide scientific bases for discovery and clinical diagnosis of cervical cancer. Firstly,the cervical cancer patients investigated in Xikou, Gushi towns and Xiushui county of Jiangxi were screened by cytology,HPV DNA detection(by HC2),electron colposcopy and cervical chemical staining. Then, the HPV genotypes were demonstrated by using GP PCR-SBT. The results indicated that the percentage of cervical precancerous lesions in the investigated areas was 5.7(14/2 460). The positive rates of high-risk HPV infection were 89.9% in patients with cervical cancer, 84.8% in CIN and 24.5% in healthy controls by HC2 method. It was also demonstrated that 10 HPV genotypes including HPV16, 58, 33,31, 18, 66, 6, 11, 56 and 81 existed in Jiangxi patients with cervical cancer by the method of GP PCR-SBT,among which HPV 81 was barely reported at home and abroad. This study suggested that vaginal infection of high-risk HPV is an important factor of cervical cancer, the rate of high-risk HPV infection was 24.5% in cervical cancer high risk areas of Jiangxi. The method for HPV genotyping has been established and the molecular mechanism of cervical cancer inducement by HPV was also discussed in this paper.