液相基因芯片技术在崇明地区人乳头瘤病毒检测和分型中...

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液相基因芯片技术在崇明地区人乳头瘤病毒检测和分型中的应用
Application of liquid gene chip technology in human papillomavirus detection and typing in Chongming area
摘要：
目的：探究液相基因芯片技术在崇明地区人乳头瘤病毒（H PV ）检测和分型中的应用。方法选取2011年5月至2013年4月该院妇科门诊就诊者宫颈脱落细胞500例，使用液相基因芯片技术对其进行 HPV基因型检测。并对80例患者进行病理诊断，根据组织病理学将80例患者分为炎性反应组、细胞学正常组、宫颈癌组、宫颈上皮内瘤变（CIN）Ⅰ组、CINⅡ组、CINⅠ～Ⅱ组、CINⅢ组。将病理诊断结果和 HPV DNA亚型分布结果结合分析，对崇明地区宫颈病变程度和HPV感染基因型的关系进行分析。结果500例标本中共180例HPV阳性患者， HPV总感染率为36％，共检出22种基因型，按照感染率从高到低依次为 HPV‐16、HPV‐52、HPV‐58、HPV‐18、HPV‐11、HPV‐6、HPV‐31。其中高危型感染为85．96％，低危型感染为14．04％。500例标本中共180例 HPV阳性患者，其中44例（24．44％）患者年龄为21～25岁的女性，11例（6．15％）患者年龄为51～67岁的女性，随着年龄的增大HPV阳性例数减少。随着宫颈病变级别的升高 HPV感染率逐渐升高，两两比较结果显示，炎性反应组与正常组、CINⅢ组与CINⅡ组、宫颈癌组与CINⅡ组、宫颈癌组与CINⅢ组之间差异无统计学意义（P＞0．05）；其余11对两两对比差异具有统计学意义（ P＜0．05）。随着宫颈病变级别的升高 H PV多重感染率逐渐升高，但是仅炎性反应组与CINⅢ、CINⅡ组间差异有统计学意义（P＜0．05）。将组织病理学作为确诊标准，液相芯片 HPV DNA检测CIN Ⅲ、CIN Ⅱ的特异度为76．63％，灵敏度为88．57％，阴性预测值为92．16％，阳性预测值为68．89％。结论崇明地区常见的 HPV 感染基因型为 HPV‐16、HPV‐52、HPV‐58、HPV‐18、HPV‐11、HPV‐6、HPV‐31。HPV阳性多发于年轻女性，且 HPV多重感染和感染率均随着宫颈病变的程度加重而加重。因而液相芯片 HPV DNA检查对大规模筛查和宫颈病变的临床诊断有十分重要的价值。

Abstract：
Objective To explore the application of the liquid gene chip technology in the human papillomavir‐us (HPV) detection and genotyping in Chongming area .Methods 500 cases of cervical exfoliated cells in the gyne‐cology outpatient department of our hospital from May 2011 to April 2013 were selected and performed the HPV genotyping by using the liquid gene chip technology .80 cases were performed the pathological diagnosis and divided into the groups of inflammation reaction ,normal cytology ,cervical cancer ,cervical intraepithelial neoplasia(CIN)Ⅰ , CINⅡ ,CINⅠ - Ⅱand CINⅢ according to the histopathology .The pathological diagnosis results and subtype distri‐bution results of HPV DNA were combined to conduct the analysis .The relationship between the degree of cervical lesions and HPV infection genotypes in Chongming area was analyzed .Results Among 500 specimens ,180 cases were HPV‐positive ,the HPV total infection rate was 36% ,22 genotypes were detected ,according to the descending order which were in turn HPV‐16 ,HPV‐52 ,HPV‐58 ,HPV‐18 ,HPV‐11 ,HPV‐6 and HPV‐31 .Among them ,the high risk infection accounted for 85 .96% and low‐risk infection for 14 .04% .Among 500 cases of samples ,180 cases were HPV‐positive patients ,including 44 patients(24 .44% ) aged 21 -25 years old ,11 cases(6 .15% ) patients aged 51-67 years old ,with age increasing ,number of HPV‐positive cases was decreased .With the increase of cervical le‐sions severity ,the HPV infection rate was increased ,the pairwise comparison showed that the differences between the inflammatory group and the normal group ,between CINⅢ and CINⅡ ,between cancer group and CINⅡ group ,be‐tween cervical cancer group and the CINⅢ group was not statistically significant (P>0 .05);the differences of pair‐wise comparison in remaining 11 pairs had statistically significant difference(P<0 .05) .With the increase of cervical lesions ,the multiple HPV infection rate was gradually increased ,but only the differences between the inflammation group with the CINⅢ ,CINⅡ groups were statistically significant(P<0 .05) .With the histopathology as the diag‐nostic standard ,in testing CINⅢ and CINⅡ by the liquid chip HPV DNA ,the specificity was 76 .63% ,the sensitivi‐ty was 88 .57% ,negative predictive value was 92 .16% and the positive predictive value was 68 .89% .Conclusion Common genotypes of HPV infection in Chongming area are HPV‐16 ,HPV‐52 ,HPV‐58 ,HPV‐18 ,HPV‐11 ,HPV‐6 and HPV‐31 .The HPV‐positive is more common in young women ,and the HPV multiple infection and infection rate are aggravated with the aggravation of cervical lesion severity .Thus the liquid chip HPV DNA examination has a very important value for large‐scale screening and clinical diagnosis of cervical lesions .


作者：张莉 [1] 冷俊 [1] 周晔 [1] 张蕾 [2] 杨惠萍 [2] 陈峰 [3]
作者单位：上海交通大学医学院附属新华医院崇明分院 检验科 202150 上海交通大学医学院附属新华医院崇明分院 妇科 202150 上海交通大学医学院附属新华医院崇明分院 病理科 202150
刊 名：检验医学与临床