摘要
目的探讨宫颈人乳头瘤病毒（HPV）在阴道上皮内瘤变（VAIN）及阴道鳞癌组织中的分布、意义及其检查的临床价值。方法对中国医科大学附属盛京医院2008年1月至2012年12月VAIN及阴道鳞癌患者共226例的HPV基因分型资料进行回顾性分析,HPV基因检测采用人乳头瘤病毒核酸扩增分型检测试剂盒方法。结果226例患者年龄20~77（45.55±11.41）岁,196例VAIN患者年龄分布20~77（44.26±10.65）岁,30例阴道鳞癌患者年龄分布27~74（54.03±12.75）岁。VAIN与阴道鳞癌的整体年龄分布明显不同（P〈0.01）。VAINⅠ、VAINⅡ、VAINⅢ、阴道壁癌分别占41.59%（94/226）、32.74%（74/226）、12.40%（28/226）和13.27%（30/226）。21种HPV型别有17种被检出,所有患者均未检出43、45、51及66型。VAIN及阴道鳞癌的HPV DNA检测结果阳性率达80.09%（181/226）,高危型人乳头瘤病毒（hr-HPV）感染阳性率为90.06%（163/181）,其中28例VAINⅢ及阴道鳞癌患者的hr-HPV DNA检测结果均为阳性;HPV 16型为引起阴道病变的主要亚型,占31.42%（71/226）,其次为58型（14.60%,33/226）、33型（10.62%、24/226）、CP8304型（9.73%,22/226）及53型（7.52%,17/226）。在各级别病变中均存在HPV型别的混合感染,单重感染率随疾病的病变程度增加而呈递增趋势,阴道鳞癌标本中作为单重感染原的HPV型别有限。结论 HPV感染与VAIN及阴道鳞癌的发生发展有关,使用HPV DNA检测技术有助于筛查阴道病变。
Objective To detect the distribution of human papillomavirus （HPV） infection in patients with vaginal intraepithelial neoplasia （VAIN） and vaginal squamous cell carcinoma in Liaoning Province, so as to analyze the significance and clinical value of the detection.Methods There were 226 patients with VAIN and vaginal squamous cell carcinoma who were treated in Shengjing Hospital from January 2008 to December 2012.Their clinical data were reviewed and HPV genotype was detected by human papillomavinm PCR types diagnostic kit.Results The age distribution between VAIN and vaginal squamous cell carcinoma patients was remarkably different （P〈0.001）.The percentage of VAIN Ⅰ ,VAIN Ⅱ ,VAIN m and vaginal squamous cell carcinoma was 41.59% （94/226）, 32.74% （74/226）,12.40% （28/226） and 13.27% （30/226）, respectively, seventeen of 21 types were detected, and types such as 43,45,51 and 66 were not in all patients. There were 80.09% （181/226） HPV （human papillomavirus）infected women in VAIN and vaginal squamous cell carcinoma, and the rate of positive infection with high-risk HPV was 90.06% （163/181）.Al1 of the VAIN Ⅲ and vaginal squamous cell carcinoma patients were infected with high-risk HPV. Multiple- genotype infections were found in all patients, but single- type infection rate increased with severity of the disease. Few HPV genotypes were found solely existing in vaginal squamous cell carcinoma group. The most common high-risk HPV types leading to VAIN and vaginal squamous cell carcinoma were HPV 16 （31.42% , 71/226）, HPV 58 （14.60%, 33/226）, HPV 33 （10.62%, 24/226）, CP8304 （9.73%, 22/226）and HPV 53 （7.52%, 17/226）.Conclusion HPV infection is closely related to the occurrence and development of VAIN and vaginal squamous cell carcinoma, and the use of HPV DNA testing technology is helpful for screening vaginal lesions.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2016年第2期163-167,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家自然科学基金(81372776)
辽宁省科学技术计划项目(2011225009)
盛京自由研究者计划(201302)
关键词
阴道上皮内瘤变
人乳头瘤病毒
感染
核酸杂交
基因型
vaginal intraepithelial neoplasia
human papillomavirus
infection
nucleic acid hybridization
genotype
