高危型HPV感染与宫颈癌及宫颈癌前病变关系的相关分析

发布时间：2018-08-26 17:33

【摘要】：研究背景宫颈癌是女性第二大常见的恶性肿瘤,其在女性恶性肿瘤中的发病率仅次于乳腺癌。有资料显示,世界范围内每年大约有近50万的宫颈癌新发病例,占所有癌症新发病例的10%;每年因宫颈癌死亡的人数已高达27万人,其中80%的病例发生在发展中国家。中国是个人口众多的国家,也是宫颈癌多发的地区。而国内绝大多数地区还未能实施有效的大规模宫颈癌筛查机制。根据统计,目前每年中国约有45700例新发宫颈癌,占世界宫颈癌新发病例总数的9.3%,宫颈癌在中国女性恶性肿瘤的发病率中排第七位,近年来,宫颈癌的发病居高不下,且有年轻化的趋势,因此宫颈癌的预防与治疗已越来越受到人们重视。国内外学者经研究发现,宫颈癌的发生和发展,与HPV(人乳头瘤病毒)感染相关,从宫颈癌防治的角度出发,明确HPV感染各亚型分布情况及感染比例,对宫颈癌前病变及宫颈癌的筛查、预防、治疗具有重要意义。研究目的:研究我院宫颈癌及癌前病变患者感染HPV的分布特点,以期能够为我市宫颈病变的临床诊断、筛选以及治疗提供参考意见,并且为宫颈HPV感染的预防提供数据支持。方法:收集2012年12月至2015年12月期间在我院妇产科就诊的深圳市妇科疾病患者,筛选出宫颈癌、CINⅠ型、CINⅡ~Ⅲ型及宫颈炎患者各120例作为研究对象,使用专用取样刷收集宫颈脱落细胞,采用亚能生物技术(深圳)有限公司提供的HPV基因分型检测试剂盒(PCR—反向斑点杂交法),对HPV进行分型检测。共检测21种HPV基因亚型,包括13种高危亚型、5种低危亚型及3种中国人常见,并且对检测结果进行统计学分析,归纳宫颈癌病理亚型及分期与HPV感染的相关性、宫颈癌前病变与HPV感染相关性、宫颈病变在不同年龄分布特点等。结果:本次研究的480份标本当中,位于宫颈鳞癌首位的HPV亚型为16型,位于腺癌首位的HPV亚型为16型,位于腺鳞癌首位的HPV亚型为16型,由此可见,病理类型HPV亚型感染首位为16型。CINⅠ中HPV亚型构成前3位依次为HPV52、16、58,CINⅡ/Ⅲ中HPV亚型构成前3位依次为HPV16、18、58,由此可见,CINⅠ中HPV基因首位亚型为HPV52,CINⅡ/Ⅲ中HPV基因首位亚型为HPV16,CINⅠ与CINⅡ/Ⅲ中常见的HPV基因亚型不尽相同,位居各年龄段HPV感染亚型首位的是16型。除此之外,宫颈癌及癌前病变与HPV多重感染的关系不明确,宫颈病变在不同年龄段分布有一定差别。结论:宫颈癌患者感染HPV的主要亚型是16型,其次是18型、52型、58型以及33型。HPV感染亚型分布与病变级别高低、宫颈癌分期、病理类型等相关,宫颈病变在不同年龄段分布有一定差别;监测高危人群,并通过疫苗接种、筛查和早诊早治等综合措施来预防宫颈癌。
[Abstract]:Background Cervical cancer is the second most common malignant tumor in women and its incidence is second only to breast cancer. Some data show that nearly 500000 new cervical cancer cases occur worldwide, accounting for 10 percent of all new cancer cases. The annual death toll from cervical cancer has reached 270000, of which 80 percent are in developing countries. China is a country with a large population and a region prone to cervical cancer. However, the vast majority of China has not been able to implement an effective large-scale cervical cancer screening mechanism. According to statistics, there are about 45700 new cases of cervical cancer in China each year, accounting for 9.3% of the total number of new cases of cervical cancer in the world. Cervical cancer ranks seventh in the incidence of malignant tumors among women in China. In recent years, the incidence of cervical cancer has remained high. And the trend of younger, so the prevention and treatment of cervical cancer has been paid more and more attention. Scholars at home and abroad have found that the occurrence and development of cervical cancer is related to the infection of HPV (human papillomavirus). From the point of view of prevention and treatment of cervical cancer, the distribution of subtypes of HPV infection and the proportion of infection are determined. Screening, prevention and treatment of precancerous lesions and cervical cancer are of great significance. Objective: to study the distribution of HPV infection in patients with cervical cancer and precancerous lesions in our hospital, in order to provide reference for clinical diagnosis, screening and treatment of cervical lesions, and to provide data support for the prevention of cervical HPV infection. Methods: from December 2012 to December 2015, the patients with gynecological diseases in Shenzhen were selected from 120 patients with cervical cancer type 鈪，

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