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目的:了解兰州市门诊病人人乳头瘤病毒(HPV)感染情况、年龄分布及与宫颈病变相关性,免疫组化法测不同宫颈病变组中P16表达,了解P16在筛查宫颈癌及其癌前病变中的作用。方法:收集兰州市2009年10月至2011年3月782例门诊女病人,核酸分子快速导流杂交基因芯片技术(HyBrimax)对宫颈脱落细胞行HPV分型检测,分析门诊病人中HPV感染状况及年龄分布。部分细胞学异常或高危HPV阳性者阴道镜下宫颈活检,病理检查宫颈病变程度及与HPV感染相关性,免疫组化法检测宫颈组织中P16蛋白表达情况。结果:兰州市门诊782例病人中,HPV阳性率28.64%(224/782),21种亚型检测出17种,排在前5位亚型分别为HPV16、HPV58、HPV68、HPV52、HPV33,各年龄组间HPV感染差异有统计学意义(P<0.05),21-30岁之间感染占37.42%。117例病检组织中,HPV在正常/炎症、CINⅠ、CINⅡ-Ⅲ、ICC组中阳性率分别为35.55%、65.60%、88.46%、100%,各组间HPV感染差异有统计学意义(P<0.01),同时P16表达依次增高,阳性率分别为22.22%、56.25%、84.61%、100%,组间差异有统计学意义(X2=36.124,P=0.001)。结论:兰州市门诊病人HPV感染阳性率为28.64%,各年龄组间感染差异有统计学意义,随宫颈病变加重,HPV检出率及P16蛋白表达均增高,二者联合检测有助于早期诊断及治疗。
Objective: To investigate the prevalence and age distribution of human papillomavirus (HPV) in outpatients in Lanzhou City and its correlation with cervical lesions. Immunohistochemistry was used to detect the expression of P16 in different cervical lesions and to understand the relationship between P16 expression in cervical cancer and its precancerous lesions The role of the lesion. Methods: A total of 782 female outpatients in Lanzhou from October 2009 to March 2011 were enrolled in this study. HyBrimax was used to detect HPV type in cervical exfoliated cells. The prevalence of HPV infection in outpatients was analyzed. age distribution. Some cytological abnormalities or high-risk HPV-positive colposcopic cervical biopsy, pathological examination of cervical lesions and HPV infection, immunohistochemical detection of cervical tissue P16 protein expression. Results: Among the 782 patients in Lanzhou City, the positive rate of HPV was 28.64% (224/782), 17 were detected in 21 subtypes, and the top 5 subtypes were HPV16, HPV58, HPV68, HPV52 and HPV33 HPV infection among the age groups was statistically significant (P <0.05), infection between 21-30 years old accounted for 37.42%. The positive rates of HPV in normal tissues, inflammatory tissues, CINⅠ, CINⅡ-Ⅲ and ICC were 35.55%, 65.60%, 88.46% and 100% respectively in 117 cases. The difference of HPV infection among groups was statistically significant (P <0.01). Meanwhile, the positive expression rates of P16 were 22.22%, 56.25%, 84.61% and 100% respectively. The difference between the two groups was statistically significant (X2 = 36.124, P = 0.001). Conclusion: The positive rate of HPV infection in outpatients in Lanzhou City was 28.64%. There was a significant difference in infection among different age groups. With the increase of cervical lesions, the detection rate of HPV and the expression of P16 protein were increased. The combined detection of HPV and HPV16 was helpful for early diagnosis And treatment.