中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2013年
3期
238-241
,共4页
叶峻杰%马丽%赵树华%李俊杰%杨丽娟
葉峻傑%馬麗%趙樹華%李俊傑%楊麗娟
협준걸%마려%조수화%리준걸%양려연
乳头状瘤病毒科%疱疹病毒2型,人%巨细胞病毒%宫颈肿瘤
乳頭狀瘤病毒科%皰疹病毒2型,人%巨細胞病毒%宮頸腫瘤
유두상류병독과%포진병독2형,인%거세포병독%궁경종류
Papillomaviridae%Herpes virus 2,human%Cytomegalovirus%Uterine cervical neoplasms
目的 调查分析育龄妇女子宫颈上皮人乳头瘤病毒(HPV)感染情况,以及单纯疱疹病毒2型(HSV-2)、人巨细胞病毒(CMV)和HPV协同感染与宫颈癌前病变发展的关系.方法 本研究为前瞻性研究,将2010年1月至2011年3月期间,昆明市健康体检的育龄妇女2128名按年龄分组为18 ～ 24岁、25 ～ 34岁、35 ～ 49岁组,采用实时荧光定量PCR技术埘其宫颈标本HPV、HSV-2、CMVDNA检测感染情况及宫颈细胞学检查,采用SPSS 13.0软件进行统计分析.结果 18 ～49岁育龄妇女生殖道高危型人乳头瘤病毒(HR-HPV)、HSV-2、CMV感染率分别为11.04％ (235/2128)、3.52％(75/2128)和5.26％(112/2128)；不同宫颈病变HR-HPV的感染率:未出现异常细胞(NILM)为4.29％ (82/1912),不明意义的不典型鳞状细胞(ASCUS)为55.93％ (66/118),鳞状上皮内低度病变(LSIL)为84.62％(44/52),鳞状上皮内高度病变(HSIL)为93.19％ (41/44),鳞状细胞癌(SCC)为2/2,感染率随宫颈癌前病变到宫颈癌发展而增加(r=0.644,P=0.000).各年龄组间HR-HPV、HSV-2感染率差异无统计学意义(x2 =2.979,P=0.226；x2=0.798,P=0.671)；18 ～24岁组的CMV感染率(7.62％)最高,且感染率随着年龄增加而下降.HSV-2、HR-HPV双重感染率在细胞学异常组(3.24％,7/216)与细胞学正常组(2.41％,46/1912)之间差异无统计学意义(x2=0.557,P=0.455),HSV-2与HR-HPV感染无明显相关性(OR=0.56,95％CI:0.17 ～ 1.82),CMV感染与HR-HPV感染存在显著相关性(OR=3.14,95％CI:1.25～7.86).结论 HR-HPV感染是宫颈癌发生的重要原因；在妇女宫颈癌前病变过程中,CMV与HR-HPV协同感染与宫颈癌前病变的发展相关,常规HPV和CMV-DNA检测在宫颈癌筛查中有重要价值.
目的 調查分析育齡婦女子宮頸上皮人乳頭瘤病毒(HPV)感染情況,以及單純皰疹病毒2型(HSV-2)、人巨細胞病毒(CMV)和HPV協同感染與宮頸癌前病變髮展的關繫.方法 本研究為前瞻性研究,將2010年1月至2011年3月期間,昆明市健康體檢的育齡婦女2128名按年齡分組為18 ～ 24歲、25 ～ 34歲、35 ～ 49歲組,採用實時熒光定量PCR技術塒其宮頸標本HPV、HSV-2、CMVDNA檢測感染情況及宮頸細胞學檢查,採用SPSS 13.0軟件進行統計分析.結果 18 ～49歲育齡婦女生殖道高危型人乳頭瘤病毒(HR-HPV)、HSV-2、CMV感染率分彆為11.04％ (235/2128)、3.52％(75/2128)和5.26％(112/2128)；不同宮頸病變HR-HPV的感染率:未齣現異常細胞(NILM)為4.29％ (82/1912),不明意義的不典型鱗狀細胞(ASCUS)為55.93％ (66/118),鱗狀上皮內低度病變(LSIL)為84.62％(44/52),鱗狀上皮內高度病變(HSIL)為93.19％ (41/44),鱗狀細胞癌(SCC)為2/2,感染率隨宮頸癌前病變到宮頸癌髮展而增加(r=0.644,P=0.000).各年齡組間HR-HPV、HSV-2感染率差異無統計學意義(x2 =2.979,P=0.226；x2=0.798,P=0.671)；18 ～24歲組的CMV感染率(7.62％)最高,且感染率隨著年齡增加而下降.HSV-2、HR-HPV雙重感染率在細胞學異常組(3.24％,7/216)與細胞學正常組(2.41％,46/1912)之間差異無統計學意義(x2=0.557,P=0.455),HSV-2與HR-HPV感染無明顯相關性(OR=0.56,95％CI:0.17 ～ 1.82),CMV感染與HR-HPV感染存在顯著相關性(OR=3.14,95％CI:1.25～7.86).結論 HR-HPV感染是宮頸癌髮生的重要原因；在婦女宮頸癌前病變過程中,CMV與HR-HPV協同感染與宮頸癌前病變的髮展相關,常規HPV和CMV-DNA檢測在宮頸癌篩查中有重要價值.
목적 조사분석육령부녀자궁경상피인유두류병독(HPV)감염정황,이급단순포진병독2형(HSV-2)、인거세포병독(CMV)화HPV협동감염여궁경암전병변발전적관계.방법 본연구위전첨성연구,장2010년1월지2011년3월기간,곤명시건강체검적육령부녀2128명안년령분조위18 ～ 24세、25 ～ 34세、35 ～ 49세조,채용실시형광정량PCR기술시기궁경표본HPV、HSV-2、CMVDNA검측감염정황급궁경세포학검사,채용SPSS 13.0연건진행통계분석.결과 18 ～49세육령부녀생식도고위형인유두류병독(HR-HPV)、HSV-2、CMV감염솔분별위11.04％ (235/2128)、3.52％(75/2128)화5.26％(112/2128)；불동궁경병변HR-HPV적감염솔:미출현이상세포(NILM)위4.29％ (82/1912),불명의의적불전형린상세포(ASCUS)위55.93％ (66/118),린상상피내저도병변(LSIL)위84.62％(44/52),린상상피내고도병변(HSIL)위93.19％ (41/44),린상세포암(SCC)위2/2,감염솔수궁경암전병변도궁경암발전이증가(r=0.644,P=0.000).각년령조간HR-HPV、HSV-2감염솔차이무통계학의의(x2 =2.979,P=0.226；x2=0.798,P=0.671)；18 ～24세조적CMV감염솔(7.62％)최고,차감염솔수착년령증가이하강.HSV-2、HR-HPV쌍중감염솔재세포학이상조(3.24％,7/216)여세포학정상조(2.41％,46/1912)지간차이무통계학의의(x2=0.557,P=0.455),HSV-2여HR-HPV감염무명현상관성(OR=0.56,95％CI:0.17 ～ 1.82),CMV감염여HR-HPV감염존재현저상관성(OR=3.14,95％CI:1.25～7.86).결론 HR-HPV감염시궁경암발생적중요원인；재부녀궁경암전병변과정중,CMV여HR-HPV협동감염여궁경암전병변적발전상관,상규HPV화CMV-DNA검측재궁경암사사중유중요개치.
Objective To investigate infection rate of human papillomavirus as well as the correlation between cervical precancerous lesions and co-infection of human HPV,herpes simple virus-2 (HSV-2) and cytomegalovirus (CMV) in Chinese women of childbearing age in Kunming,Yunnan province.Methods A total of 2128 women (18-24,25-34,35-49 years of age),who had healthy care examination in our institute from January 2010 to March 2011,were selected prospectively in this study.The infection of HPV,HSV-2 and CMV were detected by real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) and cervical precancerous lesions were determined by the ThinPrep liquid-based cytology test (TCT).Results The overall infection rates of high risk HPV (HR-HPV),HSV-2,CMV were 11.04％(235/2128),3.52％ (75/2128) and 5.26％ (112/2128),respectively.The HR-HPV infection rates in groups of Negative for Intraepithelial Lesion or Malignancy (NILM),Atypical Squamous Cells of Undetermined Significance (ASCUS),Low grade Squamous Intraepithelial Lesion (LSIL),High grade Squamous Intraepithelial Lesion(HSIL),and Squamous Cell Carcinoma (SCC) were 4.29％ (82/1912),55.93％ (66/118),84.62％ (44/52),93.19％ (41/44) and 2/2,respectively.HR-HPV infection rates was increased with the development of cervical lesion (r =0.644,P =0.000).No significant difference on the infection rates of HR-HPV and HSV-2 was identified between different age groups (x2 =2.979,P =0.226; x2 =0.798,P =0.671).The peak age groups for CMV infection (7.62％) were 18 to 24 years old and the infection rates of CMV decrease with age.No significant difference of HSV-2 and HR-HPV coinfection was found between the TCT-abnormal (3.24％,7/216) and control groups (2.41％,46/1912,x2 =0.557,P=0.455),and no relationship was found between HSV-2 and HR-HPV infection groups (OR =0.56,95％ CI:0.17-1.82).The infection of HR-HPV were related significantly with CMV infection (OR =3.14,95％ CI:1.25-7.86).Conclusion HR-HPV infection appears to be the key risk factor for cervical cancer and synergistic interaction may occur between CMV and HPV infections in the development of cervical lesion.
