[人乳头瘤病毒感染与宫颈上皮内瘤变]

[Human papillomavirus infection and cervical intraepithelial neoplasia].

作者信息

Sevcík L, Koliba P, Konderla M, Gráf P, Hlavacka J

机构信息

Porodnicko-gynekologická klinika FNsP Ostrava.

出版信息

Ceska Gynekol. 2003 Jul;68(4):237-43.

PMID:14515645

Abstract

OBJECTIVE

To determine the presence of high-risk, oncogenic types of HPV infection (HR HPV) and the presence of HPV 16 and 18 in various degrees of cervical and intraepithelial neoplasia.

TYPE OF THE STUDY

A retrospective study. NAME AND ADDRESS OF THE INSTITUTION: Obstetrical-Gynecological Clinic, Faculty Hospital, Ostrava.

METHODS

The study included 205 female patients indicated for conization due to cervical intraepithelial neoplasia. The conization was preceded by extended colposcopy, cytological samplings, HPV DNA test and a directed biopsy. HR HPV was examined in all patients, HPV 18 and 16, respectively, in 98 (48%) patients. Based on severity of histopathological findings the patients were divided into three groups, examined for positivity of oncogenic HPV types and the high risk HPV 18 and HPV 18 types, respectively.

RESULTS

The histopathological findings from a total number of 205 conuses included five (2%) benign lesions, 85 (41%) CIN1, 77 (38%) CIN 2 and 38 (19%) CIN 3. Altogether the HR HPV was demonstrated in 143 (70%) patients. In patients with the benign lesion no HPV infection was detected. In patients with the CIN 1 finding the HR HPV infection was detected in 35 (41%) cases, in patients with CIN 2 in 70 (91%) cases and in patients with CIN 3 in 38 (100%) cases. HPV 16 was diagnosed in patients with the CIN 1 finding in 9 (23%) cases, HPV 16 in 5 (6%) cases and both types of the virus were present in two (2%) cases. In CIN 2, HPV 16 was positive in 17 (43%) and HPV 18 in 6 (8%) cases. In patients with CIN 3, HPV 18 was detected in 9 (53%) and HPV 18 in 2 (5%) patients. In all the women who underwent conization, HPV 16 infection was demonstrated in 17% and HPV 18 in 6% patients. In 19% of patients, the infection by at least one type of the virus was present and in two % both types of the virus were present.

CONCLUSION

The presence of HR HPV rises with increasing severity of cervical intraepithelial neoplasia, HR HPV being detected in all cases suffering from CIN 3. The highest risk type HPV 16 was present with increasing rate in relation to the severity of cervical intraepithelial neoplasia, whereas no such trend was present in case of HPV 18.

摘要

目的

确定高危致癌型人乳头瘤病毒感染（HR HPV）的存在情况以及16型和18型人乳头瘤病毒在不同程度宫颈上皮内瘤变中的存在情况。

研究类型

一项回顾性研究。机构名称及地址：俄斯特拉发市大学医院妇产科诊所。

方法

该研究纳入了205名因宫颈上皮内瘤变而接受锥切术的女性患者。在进行锥切术之前，先进行了扩大阴道镜检查、细胞学采样、HPV DNA检测和定向活检。对所有患者检测HR HPV，分别对98名（48%）患者检测HPV 18和16。根据组织病理学检查结果的严重程度，将患者分为三组，分别检测致癌型HPV类型以及高危型HPV 18和16型的阳性情况。

结果

205例锥切标本的组织病理学检查结果包括5例（2%）良性病变、85例（41%）CIN1、77例（38%）CIN 2和38例（19%）CIN 3。共有143例（70%）患者检测到HR HPV。良性病变患者未检测到HPV感染。CIN 1患者中，35例（41%）检测到HR HPV感染；CIN 2患者中，70例（91%）检测到；CIN 3患者中，38例（100%）检测到。CIN 1患者中，9例（23%）诊断出HPV 16，5例（6%）诊断出HPV 16，两种病毒均存在的有2例（2%）。CIN 2患者中，HPV 16阳性的有17例（43%），HPV 18阳性的有6例（8%）。CIN 3患者中，9例（53%）检测到HPV 18，2例（5%）检测到HPV 18。在所有接受锥切术的女性中，17%的患者检测到HPV 16感染，6%的患者检测到HPV 18感染。19%的患者感染了至少一种病毒，2%的患者两种病毒均感染。