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目的探讨人乳头状瘤病毒(humanpa pillomavirus,HPV)16、18型在宫颈病变进展中表达意义。方法采用实时荧光定量聚合酶链反应(Real timefluorescence qaantitativePCR,PQ-PCR)分别对健康检查妇女480例、宫颈炎116例、宫颈上皮内瘤样病变(cervicalintraepithelial aeoplasia,CIN)Ⅰ级(轻度宫颈不典型增生)48例、CINⅡ级(中度宫颈不典型增生)56例、CINⅢ级(重度宫颈不典型增生及宫颈原位癌)52例进行HPV16、18型的定性、定量检测。结果健康检查者以及宫颈炎、CINⅠ、Ⅱ、Ⅲ级患者感染HPV16阳性率分别为0.63%、25.8%、30.6%、60.7%、71%,HPV16型阳性标本平均拷贝数分别为6.3×102、4.1×104、8.9×105、5.6×106、3.8×107;随着宫颈病情的进展HPV16型阳性率逐渐升高(P<0.01),感染率和病毒载量之间有正相关关系(rs=1,P<0.01);HPV18阳性率分别为0.41%、7.8%、14.6%、10.7%、7.7%,HPV18型阳性标本平均拷贝数分别为1.2×103、4.6×104、5.4×104、3.6×103、6.9×104,宫颈炎、CINⅠ、Ⅱ、Ⅲ级患者HPV18阳性率均比健康检查者明显增加(P<0.01),宫颈炎、CINⅠ、Ⅱ、Ⅲ级患者HPV18阳性率差别无统计学意义(P>0.05),感染率和病毒载量之间无正相关关系(rs=0,P>0.05)。结论宫颈病变程度与HPV16、18型感染密切相关,且宫颈病情进展和HPV16型病毒DNA负荷呈正相关。
Objective To investigate the expression of human papillomavirus (HPV) type 16 and 18 in the progression of cervical lesions. Methods Real time fluorescence quantitative PCR (PQ-PCR) was used to detect 480 cases of healthy women, 116 cases of cervicitis, 1 case of cervical intraepithelial aeoplasia (CIN), mild cervix (48 cases), 56 cases of CINⅡ (moderate cervical dysplasia), 52 cases of CINⅢ (severe cervical dysplasia and cervical carcinoma in situ). Results The positive rates of HPV16 infection in patients with cervicitis and cervicitis were 0.63%, 25.8%, 30.6%, 60.7% and 71%, respectively. The average copy number of HPV16 positive specimens was 6.3 × 102,4.1 × 104,8.9 × 105,5.6 × 106,3.8 × 107; HPV16 positive rate gradually increased with the progress of cervical disease (P <0.01), there was a positive correlation between infection rate and viral load (rs = 1 , P <0.01). The positive rates of HPV18 were 0.41%, 7.8%, 14.6%, 10.7% and 7.7% respectively. The average copy number of HPV18 positive samples were 1.2 × 103, 4.6 × 104, 5.4 × 104 and 3.6 × 103 , 6.9 × 104, cervicitis, CINⅠ, Ⅱ, Ⅲ grade HPV18 positive rate was significantly higher than the health check-up (P <0.01), cervicitis, CIN Ⅰ, Ⅱ, Ⅲ grade HPV18 positive rate was no significant difference P> 0.05). There was no positive correlation between infection rate and viral load (rs = 0, P> 0.05). Conclusion The degree of cervical lesions is closely related to HPV16 and 18 infection, and the progress of cervical disease is positively correlated with the DNA load of HPV16.