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目的探讨人乳头状瘤病毒(HPV)多重感染对宫颈癌及高度鳞状上皮内病变风险的影响。方法选取2016年1月-2017年1月在该院进行宫颈组织检查的100例女性作为研究对象,根据宫颈组织病变程度分为两组,L组(低度鳞状上皮内病变或未见上皮病变)64例和H组(高度鳞状上皮内病变或浸润性宫颈癌)36例。取宫颈标本做TCT检查、HPV-DNA分型检查和阴道镜活检,分析HPV多重感染与宫颈病变的关系。结果共检出20种HPV亚型,其中16、18、58、68 4种亚型的出现频率最高。两组患者的HPV多重感染率比较差异无统计学意义(P>0.05);不同程度宫颈病变的HPV多重感染率不同,但各组间的多重感染率比较差异无统计学意义(P>0.05)。不同类型HPV感染组别的病理分级在致病力上存在着以下关系:多重HR-HPV感染>HR-HPV感染>HR-HPV+LR-HPV感染>LR-HPV感染。结论 HPV多重感染并不会明显增加宫颈癌及高鳞状上皮内病变风险,但多重HR-HPV感染要比单一HR-HPV感染、高低危混合感染、单一LR-HPV感染的致病性强,而高低危混合感染的宫颈致病性比单一HR-HPV感染更弱。
Objective To investigate the effect of multiple human papillomavirus (HPV) infection on the risk of cervical cancer and highly squamous intraepithelial lesion. Methods 100 women who underwent cervical tissue examination from January 2016 to January 2017 in our hospital were enrolled in this study. The patients were divided into two groups according to the degree of cervical tissue lesion. Group L (low grade squamous intraepithelial lesion or no epithelium Lesions) 64 cases and H group (highly squamous intraepithelial lesion or invasive cervical cancer) in 36 cases. Cervical specimens were taken for TCT examination, HPV-DNA typing and colposcopy biopsy to analyze the relationship between HPV multiple infection and cervical lesions. Results A total of 20 HPV subtypes were detected, of which 4 subtypes of 16, 18, 58 and 68 were most frequently found. There was no significant difference in HPV multiple infection rates between the two groups (P> 0.05). HPV infection rates were different among different groups of cervical lesions, but there was no significant difference in infection rates among groups (P> 0.05) . The pathological grading of different types of HPV infection groups has the following relationship in pathogenicity: multiple HR-HPV infection> HR-HPV infection> HR-HPV + LR-HPV infection> LR-HPV infection. Conclusion Multiple HPV infection does not significantly increase the risk of cervical cancer and high-grade squamous intraepithelial lesions. However, multiple HR-HPV infection is more complicated than single HR-HPV infection and high-low risk infection. The single LR-HPV infection is highly pathogenic, However, the cervical pathogenicity of the mixed infection of high and low risk is weaker than that of single HR-HPV infection.