CAJ | 학술논문

目的调查不同宫颈病变组妇女生殖道13种高危型HPV(HR HPV)感染情况,分析HR HPV感染与宫颈病变的关系.方法选择深圳市宝安区妇幼保健院宫颈专科门诊患者350例,利用TCT技术检测其宫颈上皮细胞学状况,根据细胞学结果分组.采用多重实时PCR(mRT PCR)检测其生殖道HR HPV感染情况和病毒载量,采用χ2检验或Fisher精确概率法比较各组间HR HPV感染率,采用Kruskal-Wallis或Wilcoxon秩和检验比较各组间HR HPV阳性者的病毒载量,采用Wilcoxon秩和检验比较HR HPV阳性和阴性组的年龄分布情况.结果未见上皮内病变或恶性病变(NILM)组、意义不明的非典型鳞状上皮细胞增生(ASCUS)组、鳞状上皮细胞低度病变(LSIL)组、鳞状上皮细胞高度病变(HSIL)组的HR HPV阳性例数分别为10例(3.4%)、7例(20.0%)、11例(78.6%)和6例(6/6).NILM组HR HPV阳性率低于ASCUS组、LSIL组,ASCUS组HR HPV阳性率低于LSIL组,差异有统计学意义(χ2值分别为14.43、107.69、14.76,P均<0.01);NILM组低于HSIL组、ASCUS组低于HSIL组,差异有统计学意义(P值分别为0.000 1、0.000 4).NILM组、ASCUS组、LSIL组和HSIL组HR HPV阳性者的病毒载量分别为4.10 (3.38～6.27)、5.33 (3.63～6.66)、5.77 (4.01～7.01)和5.58 (4.19～5.85)(拷贝/ml,lg).将ASCUS组、LSIL组和HSIL组3组合并为宫颈细胞异常组,病毒载量为5.58(3.63～7.01)(拷贝/ml,lg)高于NILM组,差异有统计学意义(U=43.0,P<0.05).HR HPV阳性组平均年龄36(21～56)岁,与阴性组[33(21～58)岁]比较,差异无统计学意义(U=4 544,P>0.05).结论 HR HPV感染与宫颈病变有关;HR HPV病毒载量高低与宫颈病变程度无相关性,但病毒载量越高,存在宫颈病变的可能性越大.HR HPV阳性组与阴性组的年龄分布无差异.
목적 조사불동궁경병변조부녀생식도13충고위형HPV(HR HPV)감염정황,분석HR HPV감염여궁경병변적관계.방법 선택심수시보안구부유보건원궁경전과문진환자350례,이용TCT기술검측기궁경상피세포학상황,근거세포학결과분조.채용다중실시PCR(mRT PCR)검측기생식도HR HPV감염정황화병독재량,채용χ2검험혹Fisher정학개솔법비교각조간HR HPV감염솔,채용Kruskal-Wallis혹Wilcoxon질화검험비교각조간HR HPV양성자적병독재량,채용Wilcoxon질화검험비교HR HPV양성화음성조적년령분포정황.결과 미견상피내병변혹악성병변(NILM)조、의의불명적비전형린상상피세포증생(ASCUS)조、린상상피세포저도병변(LSIL)조、린상상피세포고도병변(HSIL)조적HR HPV양성례수분별위10례(3.4%)、7례(20.0%)、11례(78.6%)화6례(6/6).NILM조HR HPV양성솔저우ASCUS조、LSIL조,ASCUS조HR HPV양성솔저우LSIL조,차이유통계학의의(χ2치분별위14.43、107.69、14.76,P균<0.01);NILM조저우HSIL조、ASCUS조저우HSIL조,차이유통계학의의(P치분별위0.000 1、0.000 4).NILM조、ASCUS조、LSIL조화HSIL조HR HPV양성자적병독재량분별위4.10 (3.38～6.27)、5.33 (3.63～6.66)、5.77 (4.01～7.01)화5.58 (4.19～5.85)(고패/ml,lg).장ASCUS조、LSIL조화HSIL조3조합병위궁경세포이상조,병독재량위5.58(3.63～7.01)(고패/ml,lg)고우NILM조,차이유통계학의의(U=43.0,P<0.05).HR HPV양성조평균년령36(21～56)세,여음성조[33(21～58)세]비교,차이무통계학의의(U=4 544,P>0.05).결론 HR HPV감염여궁경병변유관;HR HPV병독재량고저여궁경병변정도무상관성,단병독재량월고,존재궁경병변적가능성월대.HR HPV양성조여음성조적년령분포무차이.
Objective To investigate 13 high-risk types of HPV (HR HPV) infection rates in women with different grades of cervical lesions.Methods A total of 350 women, who were hospitalized in the department of gynecology in Bao′an Maternity & Child health hospital, were enrolled for the study.TCT technology was used to evaluate the cervical epithelium.The group were divided according to the cytology results.Multiplex real time PCR (mRT PCR) was used to detect the viral loads.HR HPV infection rate of different groups were analyzed using χ2 test or Fisher exact test.HR HPV viral loads of patients in different grades of cervical lesion groups were compared using Kruskal-Wallis or Wilcoxon test, and the age distribution of HR HPV positive group and negative group was analyzed by using Wilcoxon test.Results The HR HPV infection rates of NILM, ASCUS, LSIL, HSIL were 3.4% (10/295), 20.0% (7/35), 78.6% (11/14) and 100.0% (6/6), respectively.HR HPV positivity in NILM was lower than ASCUS (χ2=14.43,P<0.01) and LSIL (χ2=107.69,P<0.01), HR HPV positivity in ASCUS was lower than LSIL (χ2=14.76,P<0.01). The median of HR HPV viral loads in NILM, ASCUS, LSIL and HSIL were 4.10 (3.38-6.27), 5.33 (3.63-6.66), 5.77 (4.01-7.01) and 5.58 (4.19-5.85) respectively (copies/ml,lg).Combined ASCUS, LSIL and HSIL groups into cervical lesion group, HR HPV viral load of which was higher than that of NILM (U=43.0, P<0.05).The median Ages of HR HPV positive group and negative group were 36 and 33, respectively.No statistical significance was found between them (U=4 544, P>0.05).Conclusions The present study revealed that HR HPV infection was related to cervical lesion, but there was no correlation between viral load and cervical lesion grade. In additional, no difference in age distribution was found between HR HPV positive group and negative group.