不同宫颈上皮内瘤变阶段患者感染人乳头瘤病毒的基因型差异分析

喻静敏; 陈燕; 杨学稳

doi:10.19428/j.cnki.sjpm.2024.24333

不同宫颈上皮内瘤变阶段患者感染人乳头瘤病毒的基因型差异分析

Analysis of HPV genotype differences in different stages of cervical intraepithelial neoplasia

摘要

摘要:
目的探究不同宫颈上皮内瘤变（cervical intraepithelial neoplasia, CIN）阶段人乳头瘤病毒（human papillomavirus, HPV）基因型差异。
方法本研究回顾性选取2020年4月至2023年3月杭州市第三人民医院收治的CIN患者113例，依据CIN进展程度分为CIN Ⅰ级（n=30）、CIN Ⅱ级（n=42）和CIN Ⅲ级（n=41），分析CIN进展程度的影响因素，并对检测HPV基因分型。采用logistic回归分析HPV基因分型与CIN进展程度的关系，并分析HPV基因分型与CIN进展程度影响因素的交互作用。
结果 HPV感染基因型分析显示，HPV16、HPV58、HPV18、HPV52是CIN患者HPV感染最常见的基因型，CIN I级患者阴性人数占比（53.33%）高于CIN Ⅱ级（33.33%）和CIN Ⅲ级（0）患者，HPV16、HPV58、HPV18、HPV52的感染率及多重感染率（3.33%、3.33%、0、0及0）低于CIN Ⅱ级（7.14%、4.76%、2.38%、4.76%及2.38%）和CIN Ⅲ级（24.39%、19.51%、12.20%、14.63%及12.20%）患者（P<0.05）。校正混杂因素后，HPV16、HPV18、HPV52、HPV58仍和CIN进展程度显著相关（P<0.05）。性伴侣数≥2（OR=3.529，95%CI：2.756~6.925，P=0.025）、分泌物异味（OR=5.684，95%CI：2.439~8.942，P=0.036）、接触性出血（OR=2.679，95%CI：1.627~3.192，P=0.018）、慢性宫颈炎（OR=3.894，95%CI：1.952~4.931，P=0.031）与CIN进展程度呈正相关。HPV16、HPV18、HPV52、HPV58和性伴侣数、分泌物异味、接触性出血、慢性宫颈炎均有正交互作用（P<0.05）。
结论 CIN患者HPV感染以HPV16、HPV58、HPV18、HPV52为主要基因型，与CIN进展程度呈正相关，并与相关影响因素存在密切关系。

Abstract:
Objective To explore the differences in human papillomavirus (HPV) genotype among patients with varying stages of cervical intraepithelial neoplasia (CIN).
Methods This retrospective study included 113 patients with CIN who were treated at the Third People’s Hospital of Hangzhou from April 2020 to March 2023. The patients were divided into three groups based on the progression of CIN: CIN Ⅰ (n=30), CIN Ⅱ (n=42), and CIN Ⅲ (n=41). The influencing factors of CIN progression were analyzed, and HPV genotyping was performed logistic regression analysis was used to examine relationship between HPV genotypes and the degree of CIN progression, and the interaction between HPV genotypes and CIN progression-related factors were assessed.
Results HPV genotype analysis revealed that HPV16, HPV58, HPV18, and HPV52 were the most common genotypes among CIN patients. The proportion of negative HPV cases in CIN I patients (53.33%) was significantly higher than that in CIN Ⅱ (33.33%) and CIN Ⅲ (0) patients. The infection rates and multiple infection rates of HPV16, HPV58, HPV18, and HPV52 (3.33%, 3.33%, 0, 0, 0.) were significantly lower in CIN Ⅰ patients compared to CIN Ⅱ (7.14%, 4.76%, 2.38%, 4.76%, 2.38%) and CIN Ⅲ patients (24.39%, 19.51%, 12.20%, 14.63%, 12.20%) (P<0.05). After adjusting for confounding factors, HPV16, HPV18, HPV52, and HPV58 remained significantly associated with the progression of CIN (P<0.05). Having ≥2 sexual partners (OR=3.529, 95%CI: 2.756~6.925, P=0.025), abnormal discharge odor (OR=5.684, 95%CI: 2.439~8.942, P=0.036), contact bleeding (OR=2.679, 95%CI: 1.627~3.192, P=0.018), and chronic cervicitis (OR=3.894, 95%CI: 1.952~4.931, P=0.031) were independent factors influencing the progression of CIN. HPV16, HPV18, HPV52, HPV58 exhibited positive interactions with the number of sexual partners, abnormal discharge odor, contact bleeding, and chronic cervicitis (P<0.05).
Conclusion HPV16, HPV58, HPV18, and HPV52 are the most common genotypes of HPV infection in CIN patients, which are positively correlated with the degree of CIN progression. These genotypes are also closely related to factors influencing CIN progression.

HTML全文

参考文献(25)

施引文献

资源附件(0)