HPV感染型别及多重感染与女性宫颈病变的关联性分析

徐露露; 张琴; 孙梅

doi:10.13898/j.cnki.issn.1000-2200.2023.05.020

HPV感染型别及多重感染与女性宫颈病变的关联性分析

Analysis of the relationship between type of HPV infection and multiple infection and female cervical lesion

摘要

摘要:
目的分析人乳头瘤病毒(human papilloma virus，HPV)感染型别及多重感染与女性宫颈病变的关联性。
方法选取行HPV分型检查以及液基薄层细胞学检查(TCT)的6 000份检测样品进行回顾性分析。首先通过TCT检查对样本进行筛查，然后分析样本的HPV感染型别及多重感染情况。采用宫颈组织病理活检方法确定病人的宫颈病变情况，分析不同HPV感染型别病人的宫颈病变情况，观察单一感染和多重感染女性的宫颈病变情况，分析HPV感染型别及多重感染与女性宫颈病变的相关性。
结果6 000份HPV检测样本中，1 034份为HPV阳性，阳性率为17.23%；HPV感染病人中检测出21个基因亚型，其中高危型感染的前三位是HPV16、HPV52和HPV56，低危型感染最多的是HPV6。HPV阳性病人中慢性炎症疾病634份(61.32%)，宫颈上皮内瘤变(CIN)Ⅰ级208份(20.12%)，CINⅡ~Ⅲ级128份(12.38%)，宫颈癌64份(6.18%)。logistic回归分析显示，HPV16和HPV18感染与宫颈癌发生具有密切关联(P < 0.01和P < 0.05)。HPV阳性病人中单一感染761份(73.60%)，多重感染273份(26.40%)；不同宫颈病变分级病人中大部分为单一感染，且随着病变严重程度的增加，单一感染占比明显上升，多重感染占比降低(P < 0.01)。
结论HPV感染型别中，HPV16和HPV18是影响女性宫颈病变发展速度的高风险因素，是否为多重感染与女性宫颈病变具有明显关联性，宫颈病变病人以HPV单一感染为主。

Abstract:
ObjectiveTo analyze the relationship between type of human papilloma virus (HPV) infection and multiple infection and female cervical lesion.
MethodsA total of 6 000 samples for HPV typing and thin-prep cytology test (TCT) were selected for retrospective analysis.First, the samples were screened by TCT, and then the type of HPV infection and multiple infection of the samples were analyzed.The cervical pathological biopsy method was used to determine the cervical lesions of patients, the cervical lesions of patients with different types of HPV infection were analyzed, the cervical lesions of women with single infection and multiple infection were observed, and the relationship between type of HPV infection and multiple infection and female cervical lesion.
ResultsAmong the 6 000 HPV test samples, 1 034 were HPV-positive, with a positive rate of 17.23%.Among the patients with HPV infection, 21 gene subtypes were detected, in which the top three high-risk types were HPV16, HPV52 and HPV56, and the most type of low-risk infection was HPV6.Among HPV-positive patients, 634 cases(61.32%) were with chronic inflammatory diseases, 208 cases (20.12%) with cervical intraepithelial neoplasia(CIN) grade Ⅰ, 128 cases (12.38%) with CIN grade Ⅱ-Ⅲ, and 64 cases (6.18%) with cervical cancer.Logistic regression analysis showed that HPV16 and HPV18 infection were closely associated with cervical cancer(P < 0.01 and P < 0.05).Among HPV-positive patients, 761 cases(73.60%) were single infection and 273 cases(26.40%) were multiple infection.Most of the patients with different grades of cervical lesions were single infection, and with the increase of the severity of the lesions, the proportion of single infection increased significantly, while the proportion of multiple infection decreased(P < 0.01).
ConclusionsAmong the type of HPV infection, HPV16 and HPV18 are the high-risk factors affecting the development rate of female cervical lesions.Multiple infection or not is significantly associated with female cervical lesion.Patients with cervical lesion mainly have HPV single infection.

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