【摘要】：研究背景宮頸癌是女性第二大常見(jiàn)的惡性腫瘤,其在女性惡性腫瘤中的發(fā)病率僅次于乳腺癌。有資料顯示,世界范圍內(nèi)每年大約有近50萬(wàn)的宮頸癌新發(fā)病例,占所有癌癥新發(fā)病例的10%;每年因?qū)m頸癌死亡的人數(shù)已高達(dá)27萬(wàn)人,其中80%的病例發(fā)生在發(fā)展中國(guó)家。中國(guó)是個(gè)人口眾多的國(guó)家,也是宮頸癌多發(fā)的地區(qū)。而國(guó)內(nèi)絕大多數(shù)地區(qū)還未能實(shí)施有效的大規(guī)模宮頸癌篩查機(jī)制。根據(jù)統(tǒng)計(jì),目前每年中國(guó)約有45700例新發(fā)宮頸癌,占世界宮頸癌新發(fā)病例總數(shù)的9.3%,宮頸癌在中國(guó)女性惡性腫瘤的發(fā)病率中排第七位,近年來(lái),宮頸癌的發(fā)病居高不下,且有年輕化的趨勢(shì),因此宮頸癌的預(yù)防與治療已越來(lái)越受到人們重視。國(guó)內(nèi)外學(xué)者經(jīng)研究發(fā)現(xiàn),宮頸癌的發(fā)生和發(fā)展,與HPV(人乳頭瘤病毒)感染相關(guān),從宮頸癌防治的角度出發(fā),明確HPV感染各亞型分布情況及感染比例,對(duì)宮頸癌前病變及宮頸癌的篩查、預(yù)防、治療具有重要意義。研究目的:研究我院宮頸癌及癌前病變患者感染HPV的分布特點(diǎn),以期能夠?yàn)槲沂袑m頸病變的臨床診斷、篩選以及治療提供參考意見(jiàn),并且為宮頸HPV感染的預(yù)防提供數(shù)據(jù)支持。方法:收集2012年12月至2015年12月期間在我院婦產(chǎn)科就診的深圳市婦科疾病患者,篩選出宮頸癌、CINⅠ型、CINⅡ~Ⅲ型及宮頸炎患者各120例作為研究對(duì)象,使用專(zhuān)用取樣刷收集宮頸脫落細(xì)胞,采用亞能生物技術(shù)(深圳)有限公司提供的HPV基因分型檢測(cè)試劑盒(PCR—反向斑點(diǎn)雜交法),對(duì)HPV進(jìn)行分型檢測(cè)。共檢測(cè)21種HPV基因亞型,包括13種高危亞型、5種低危亞型及3種中國(guó)人常見(jiàn),并且對(duì)檢測(cè)結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析,歸納宮頸癌病理亞型及分期與HPV感染的相關(guān)性、宮頸癌前病變與HPV感染相關(guān)性、宮頸病變?cè)诓煌挲g分布特點(diǎn)等。結(jié)果:本次研究的480份標(biāo)本當(dāng)中,位于宮頸鱗癌首位的HPV亞型為16型,位于腺癌首位的HPV亞型為16型,位于腺鱗癌首位的HPV亞型為16型,由此可見(jiàn),病理類(lèi)型HPV亞型感染首位為16型。CINⅠ中HPV亞型構(gòu)成前3位依次為HPV52、16、58,CINⅡ/Ⅲ中HPV亞型構(gòu)成前3位依次為HPV16、18、58,由此可見(jiàn),CINⅠ中HPV基因首位亞型為HPV52,CINⅡ/Ⅲ中HPV基因首位亞型為HPV16,CINⅠ與CINⅡ/Ⅲ中常見(jiàn)的HPV基因亞型不盡相同,位居各年齡段HPV感染亞型首位的是16型。除此之外,宮頸癌及癌前病變與HPV多重感染的關(guān)系不明確,宮頸病變?cè)诓煌挲g段分布有一定差別。結(jié)論:宮頸癌患者感染HPV的主要亞型是16型,其次是18型、52型、58型以及33型。HPV感染亞型分布與病變級(jí)別高低、宮頸癌分期、病理類(lèi)型等相關(guān),宮頸病變?cè)诓煌挲g段分布有一定差別;監(jiān)測(cè)高危人群,并通過(guò)疫苗接種、篩查和早診早治等綜合措施來(lái)預(yù)防宮頸癌。
[Abstract]:Background Cervical cancer is the second most common malignant tumor in women and its incidence is second only to breast cancer. Some data show that nearly 500000 new cervical cancer cases occur worldwide, accounting for 10 percent of all new cancer cases. The annual death toll from cervical cancer has reached 270000, of which 80 percent are in developing countries. China is a country with a large population and a region prone to cervical cancer. However, the vast majority of China has not been able to implement an effective large-scale cervical cancer screening mechanism. According to statistics, there are about 45700 new cases of cervical cancer in China each year, accounting for 9.3% of the total number of new cases of cervical cancer in the world. Cervical cancer ranks seventh in the incidence of malignant tumors among women in China. In recent years, the incidence of cervical cancer has remained high. And the trend of younger, so the prevention and treatment of cervical cancer has been paid more and more attention. Scholars at home and abroad have found that the occurrence and development of cervical cancer is related to the infection of HPV (human papillomavirus). From the point of view of prevention and treatment of cervical cancer, the distribution of subtypes of HPV infection and the proportion of infection are determined. Screening, prevention and treatment of precancerous lesions and cervical cancer are of great significance. Objective: to study the distribution of HPV infection in patients with cervical cancer and precancerous lesions in our hospital, in order to provide reference for clinical diagnosis, screening and treatment of cervical lesions, and to provide data support for the prevention of cervical HPV infection. Methods: from December 2012 to December 2015, the patients with gynecological diseases in Shenzhen were selected from 120 patients with cervical cancer type 鈪，

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