子宫颈低级别鳞状上皮内病变与HR-HPV的关系

摘要

目的 探讨高危型人乳头状瘤病毒(high risk human papillomavirus,HR-HPV)在子宫颈低级别鳞状上皮内病变(lowgrade squamous intraepithelial lesion,LSIL)中的分布特点及感染方式,并分析其在LSIL中的作用.方法 应用实时荧光定量PCR和HPV原位杂交技术对328例诊断结果为168例LSIL、160例高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)的子宫颈组织蜡块进行HPV分型检测.结果 HE染色结果显示,LSIL的病变细胞集中在子宫颈鳞状上皮表层,HSIL的病变细胞主要集中在上皮下层.168例LSIL患者中HR-HPV阳性率95.2％;LSIL、HSIL中HPV 16、18阳性率分别为26.2％、57.5％,其他型HR-HPV(不包括HPV 16、18)的阳性率分别为80.9％、55.0％,差异均有统计学意义(P ＜0.001).在原位杂交检测组中,HR-HPV的阳性率为70.2％,HR-HPV阳性LSIL中,棕黄色阳性细胞位于子宫颈鳞状上皮表层、中层,基底层未见阳性细胞.结论 HR-HPV感染与LSIL的发生、发展密切相关,尤其是其他型HR-HPV(不包括HPV 16、18);LSIL患者中HR-HPV的感染开始于子宫颈鳞状上皮表层.%Purpose To study the infection mode and distribution of high risk human papillomavirus (HR-HPV) in lowgrade squamous intraepithelial lesions (LSILs) and to analysis its effect.Methods HPV genotype of 328 cervical tissues embedded by paraffin which contained 168 LSILs and 160 highgrade squamous intraepithelial lesions (HSILs) were detected by the methods of real-time fluorescence quantitative PCR and in situ hybridization.Results Diseased cells of LSIL stained with hematoxylin and eosin(HE) were concentrated in the upper layer of the cervical squamous epithelium,whereas HSIL were concentrated in the lower layer of the epithelium in HE staining.In LSIL,the positive ratcs of HR-HPV was 95.2％.In LSIL and HSIL,HPV 16/18 positive rates were 26.2％,57.5％,respectively.Other HR-HPV positive rates were 80.9％,55.0％,respectively.The differences were statistically significant (P ＜0.001).HR-HPV positive rate was 70.2％ in the group of in situ hybridization.The positive cells were confined to the surface and middle layer of the LSIL cervical squamous epithelium.Conclusion HR-HPV infection is closely related to LSIL,especially other HR-HPV (except for HPV 16/18).The infection mode of HR-HPV in LSIL starts from the surface layer of the cervical squamous epithelium.