CAJ | 학술논문

目的：：分析宫颈上皮内瘤变( CIN)及宫颈癌( CC)中人乳头状瘤病毒( HPV)亚型,探讨HPV感染与宫颈病变的相关性。方法：慢性宫颈炎或液基细胞学异常的妇女检测21种HPV基因亚型和阴道镜下宫颈定位活检,分析2481例CC和CIN患者的HPV感染情况。结果：在2481例CIN和CC患者中,HPV感染率85．0%,HPV感染与宫颈组织学结果有较强的相关性(P<0．001,Pearson列联系数=0．648)。 CC及CINⅢ、CINⅡ患者以HPV16、18感染最多见,其次见HPV58、33、31、52、45、59、68等亚型。304例患者宫颈感染HPV16、18、58、52、33等亚型后,发生高度鳞状上皮内病变(HSIL)、不明意义的非典型鳞状细胞(ASCUS)及低度鳞状上皮内病变(LSIL)的频率增加,TCT分型与HPV分型有较弱的相关关系(P=0．002,Pearson列联系数=0．322)。细胞学结果提示HSIL、AS-CUS,宫颈组织学诊断以CC、CINIII和CINII为多,TCT分型与组织学分型也有较弱的相关性( P=0．026,Pearson列联系数=0．172)。结论：HPV16、18、58、33、52、31、45等高危型HPV感染是宫颈癌( CC)及癌前病变( CIN)最常见的风险因素。高危型HPV单独或混合感染宫颈后,细胞学检测HSIL、ASCUS及LSIL的发生率增加,细胞学结果与组织学分型的相关性促进了CC和CIN的及时诊治。
목적：：분석궁경상피내류변( CIN)급궁경암( CC)중인유두상류병독( HPV)아형,탐토HPV감염여궁경병변적상관성。방법：만성궁경염혹액기세포학이상적부녀검측21충HPV기인아형화음도경하궁경정위활검,분석2481례CC화CIN환자적HPV감염정황。결과：재2481례CIN화CC환자중,HPV감염솔85．0%,HPV감염여궁경조직학결과유교강적상관성(P<0．001,Pearson렬련계수=0．648)。 CC급CINⅢ、CINⅡ환자이HPV16、18감염최다견,기차견HPV58、33、31、52、45、59、68등아형。304례환자궁경감염HPV16、18、58、52、33등아형후,발생고도린상상피내병변(HSIL)、불명의의적비전형린상세포(ASCUS)급저도린상상피내병변(LSIL)적빈솔증가,TCT분형여HPV분형유교약적상관관계(P=0．002,Pearson렬련계수=0．322)。세포학결과제시HSIL、AS-CUS,궁경조직학진단이CC、CINIII화CINII위다,TCT분형여조직학분형야유교약적상관성( P=0．026,Pearson렬련계수=0．172)。결론：HPV16、18、58、33、52、31、45등고위형HPV감염시궁경암( CC)급암전병변( CIN)최상견적풍험인소。고위형HPV단독혹혼합감염궁경후,세포학검측HSIL、ASCUS급LSIL적발생솔증가,세포학결과여조직학분형적상관성촉진료CC화CIN적급시진치。
Objective: To investigate 21 HPV genotypes infection in cervical cancer and cervical intraepithelial neoplasia ( CIN) , and the relationship between HPV infections and cervical cancer. Methods:Cases with chronic cervici-tis or abnormal cervical cells detected by liquid-based Thinprep cytology test ( TCT) had 21 HPV genotypes detected and accepted cervical biopsy during colposcopy. HPV infection status in 2 481 cases with cervical carcinoma or cervical intraep-ithelial neoplasia were analyzed. Results: Among 2 481 cases of CIN and cervical carcinoma, HPV-positive patients ac-counted for 85. 0%. There was statistically significant relevance between HPV infection and abnormal cervical histology (P<0. 001, Pearson correlation coefficient=0. 648). HPV16, HPV18 infection were most common in patients with CC and CINⅢ, CINⅡ, followed by HPV58, HPV 33, HPV31, HPV52, HPV45, HPV59, HPV68 subtype infections. In 304 pa-tients who got cervical infection with a subtype of HPV16, HPV18, HPV58, HPV52, HPV33, the incidence of high-grade squamous intraepithelial lesions (HSIL), atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) rose significant (P=0. 002, Pearson correlation coefficient=0. 322). Morover, CC, CIN III and CIN II had a high rate of HSIL, ASCUS. There were significant correlations between abnormal cervical cytology and histological results (P=0. 026, Pearson correla-tion coefficient=0. 172). Conclusion:Infection of high risk HPV types such as HPV16, HPV18, PHV58, HPV33, HPV52, HPV31, HPV45 is the main risk factor of cervical carcinoma ( CC) and precancerous lesion ( CIN) . With high-risk HPV infection, cervical cytologic diagnoses of HSIL, ASCUS and LSIL increase. The correlation between cytological and histological findings for CC and CIN promotes timely detection, prevention, intervention,and effective treatment.