温州医科大学学报
溫州醫科大學學報
온주의과대학학보
Journal of Wenzhou Medical University
2015年
10期
738-743
,共6页
陈艳%林琳%贾志强%陈尼娅
陳豔%林琳%賈誌彊%陳尼婭
진염%림림%가지강%진니아
宫颈上皮内瘤样病变%γ干扰素基因多态性%乳头状瘤病毒%病毒负荷量
宮頸上皮內瘤樣病變%γ榦擾素基因多態性%乳頭狀瘤病毒%病毒負荷量
궁경상피내류양병변%γ간우소기인다태성%유두상류병독%병독부하량
cervical intra-epithelial neoplasia%interferon-gamma gene polymorphism%human papilloma virus%viral load
目的：探讨高危型人乳头状瘤病毒（HPV）载量及γ干扰素（IFNγ）基因多态性与宫颈上皮内瘤变（CIN）患者经环状电圈切除（LEEP）术后病灶残留或复发的关系，以及发病过程中的相关性。方法：所选来自本院门诊或住院行LEEP术的HPV阳性患者共439例，并选取同期体检HPV阴性的健康女性120例作为对照，采用基因测序方法检测IFNγ基因多态性，术后3、6、9、12个月时复查高危型HPVDNA及宫颈新柏氏液基细胞学（TCT）检测。结果：IFNγ基因多态性rs243056l位点TT基因型为HPV感染发病的保护因素（OR为0.471，95%CI：0.283～0.783；x2=8.702；P=0.003），AA基因型为HPV感染发病的危险因素（OR为1.688，95%CI：1.108～2.572；x2=6.005；P=0.014），术前及术后3个月HPV载量与病灶残留/复发相关（P＜0.05）。Kaplan-Meier分析结果显示，AA与TT基因型HPV感染累积阴性率有显著差异（log-rank=15.414，P＜0.001），AA基因型女性HPV感染的累积阴性率最低，病灶残留/复发率为45.65%。结论：术前及术后3个月高危型HPV载量与CIN的发生、进展及CIN患者LEEP术预后有关。IFNγ基因rs2430561位点多态性影响女性宫颈HPV的易感性，AA基因型女性感染风险更高，并易于HPV感染的持续和复发。
目的：探討高危型人乳頭狀瘤病毒（HPV）載量及γ榦擾素（IFNγ）基因多態性與宮頸上皮內瘤變（CIN）患者經環狀電圈切除（LEEP）術後病竈殘留或複髮的關繫，以及髮病過程中的相關性。方法：所選來自本院門診或住院行LEEP術的HPV暘性患者共439例，併選取同期體檢HPV陰性的健康女性120例作為對照，採用基因測序方法檢測IFNγ基因多態性，術後3、6、9、12箇月時複查高危型HPVDNA及宮頸新柏氏液基細胞學（TCT）檢測。結果：IFNγ基因多態性rs243056l位點TT基因型為HPV感染髮病的保護因素（OR為0.471，95%CI：0.283～0.783；x2=8.702；P=0.003），AA基因型為HPV感染髮病的危險因素（OR為1.688，95%CI：1.108～2.572；x2=6.005；P=0.014），術前及術後3箇月HPV載量與病竈殘留/複髮相關（P＜0.05）。Kaplan-Meier分析結果顯示，AA與TT基因型HPV感染纍積陰性率有顯著差異（log-rank=15.414，P＜0.001），AA基因型女性HPV感染的纍積陰性率最低，病竈殘留/複髮率為45.65%。結論：術前及術後3箇月高危型HPV載量與CIN的髮生、進展及CIN患者LEEP術預後有關。IFNγ基因rs2430561位點多態性影響女性宮頸HPV的易感性，AA基因型女性感染風險更高，併易于HPV感染的持續和複髮。
목적：탐토고위형인유두상류병독（HPV）재량급γ간우소（IFNγ）기인다태성여궁경상피내류변（CIN）환자경배상전권절제（LEEP）술후병조잔류혹복발적관계，이급발병과정중적상관성。방법：소선래자본원문진혹주원행LEEP술적HPV양성환자공439례，병선취동기체검HPV음성적건강녀성120례작위대조，채용기인측서방법검측IFNγ기인다태성，술후3、6、9、12개월시복사고위형HPVDNA급궁경신백씨액기세포학（TCT）검측。결과：IFNγ기인다태성rs243056l위점TT기인형위HPV감염발병적보호인소（OR위0.471，95%CI：0.283～0.783；x2=8.702；P=0.003），AA기인형위HPV감염발병적위험인소（OR위1.688，95%CI：1.108～2.572；x2=6.005；P=0.014），술전급술후3개월HPV재량여병조잔류/복발상관（P＜0.05）。Kaplan-Meier분석결과현시，AA여TT기인형HPV감염루적음성솔유현저차이（log-rank=15.414，P＜0.001），AA기인형녀성HPV감염적루적음성솔최저，병조잔류/복발솔위45.65%。결론：술전급술후3개월고위형HPV재량여CIN적발생、진전급CIN환자LEEP술예후유관。IFNγ기인rs2430561위점다태성영향녀성궁경HPV적역감성，AA기인형녀성감염풍험경고，병역우HPV감염적지속화복발。
Objective:To investigate the association of interferon-gamma gene polymorphisms and the cor-relation between viral load remains and recidivation after loop ment for CIN patients. Methods:Performed gene analysis was used for detection of polymorphisms in interferon-gamma gene in 439 HPV positive patients under-gone the LEEP treatment for CIN and 120 HPV negative normal controls, reviewed high-risk HPV DNA and cer-vix uterus TCT were reviewed in 3, 6, 9 and 12 months after treatment. Results:That the individuals with the TT genotype showed statistically signiifcant had protection against HPV infection (OR=0.471, 95%CI=0.283~0.783;x2=8.702, P=0.003). That the individuals with the AA genotype showed statistically signiifcant increased risk for HPV infection (OR=1.688, 95%CI=1.108~2.572;x2=6.005, P=0.014). The viral load before and after 3 months LEEP treatment of high-risk HPV was a risk factor of remains or recidivation after LEEP treatment (P<0.05). In the analysis of Kaplan-Meier, the cumulative HPV negative rates of AA and TT genotype exhibited signiifcantly different (log-rank=15.414, P<0.001). The cumulative HPV negative rate of AA genotype was the lowest, the remains or recidivation rate of AA genotype was 45.65%. Conclusion:The viral load before and after 3 months LEEP treatment of high-risk HPV is related to CIN and the prognosis for CIN patients. Interferon-gamma gene rs2430561 polymorphisms affects the susceptibility to HPV infection. Women with AA genotype exhibited higher risk of infection and inclined to be continuous status and recurrence after HPV infection.
