Ma Li, Cong Xiao, Shi Mai, Wang Xiu-Hong, Liu Hai-Yan, Bian Mei-Lu
Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing 100029, P.R. China.
Exp Ther Med. 2017 Feb;13(2):535-541. doi: 10.3892/etm.2016.4000. Epub 2016 Dec 27.
The aims of the present study were to investigate the distribution of human papillomavirus (HPV) genotypes in cervical lesions, and the association between different HPV genotypes and cervical lesions. Between January 2013 and June 2014, the HPV type determinations of nucleic acid by use of fluorescence polymerase chain reaction (PCR) method of 15,192 outpatients in China-Japan Friendship Hospital were performed and the infection status was analyzed. The results showed that: i) 2,366 Cases were HPV positive and 12,826 cases were HPV negative, the overall infection rate was 15.57% (2,366/15,192), in which a single genotype of HPV infection rate was 11.63% (1,767/15,192), and multiple genotypes of HPV infection rate was 3.94% (599/15,192); ii) HPV16, HPV52 and HPV58 infections were the most common HPV genotypes, the infection rates were 3.95% (600/15,192), 2.86% (435/15,192) and 2.67% (406/15,192), respectively; and iii) According to the gold standard of histopathological analysis via hematoxylin-eosin staining, HPV16, HPV52 and HPV58 accounted for 58.80% (154/267) of all CIN2 or above squamous epithelial lesions. Furthermore, three cases with pathological changes of the cervical severe glandular epithelium were all HPV18 infection. The difference was statistically significant (χ=60.74, P<0.001). Single HPV subtype infection was primarily associated with HPV16, HPV52 and HPV58. In conclusion, HPV type detection had a may be important in screening of cervical lesions as a difference in pathogenic ability was noted among different HPV genotypes. As cervical cancer is an infectious disease, HPV testing may help detect more precancerous lesions, thus reducing the morbidity and mortality of cervical cancer. HPV16, HPV52 and HPV58 were associated with severe cervical squamous epithelial lesions; HPV18 was associated with cervical severe glandular cell pathological changes, although it was not the most common HPV genotype in China. When positive, a clinical cervical examination should be conducted, including colposcopy and biopsy.
本研究的目的是调查人乳头瘤病毒（HPV）基因型在宫颈病变中的分布情况，以及不同HPV基因型与宫颈病变之间的关联。2013年1月至2014年6月期间，对中日友好医院15192名门诊患者采用荧光聚合酶链反应（PCR）方法进行HPV核酸分型检测，并分析感染状况。结果显示：i）2366例HPV阳性，12826例HPV阴性，总体感染率为15.57%（2366/15192），其中单一基因型HPV感染率为11.63%（1767/15192），多重基因型HPV感染率为3.94%（599/15192）；ii）HPV16、HPV52和HPV58感染是最常见的HPV基因型，感染率分别为3.95%（600/15192）、2.86%（435/15192）和2.67%（406/15192）；iii）根据苏木精-伊红染色组织病理学分析的金标准，HPV16、HPV52和HPV58在所有CIN2及以上鳞状上皮病变中占58.80%（154/267）。此外，3例宫颈重度腺上皮病变患者均为HPV18感染。差异具有统计学意义（χ=60.74，P<0.001）。单一HPV亚型感染主要与HPV16、HPV52和HPV58相关。总之，由于不同HPV基因型的致病能力存在差异，HPV分型检测在宫颈病变筛查中可能具有重要意义。由于宫颈癌是一种传染病，HPV检测可能有助于发现更多癌前病变，从而降低宫颈癌的发病率和死亡率。HPV16、HPV52和HPV58与重度宫颈鳞状上皮病变相关；HPV18与宫颈重度腺细胞病理改变相关，尽管它不是中国最常见的HPV基因型。检测结果为阳性时，应进行临床宫颈检查，包括阴道镜检查和活检。
