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目的探讨宫颈人乳头瘤病毒(HPV)在阴道上皮内瘤变(VAIN)及阴道鳞癌组织中的分布、意义及其检查的临床价值。方法对中国医科大学附属盛京医院2008年1月至2012年12月VAIN及阴道鳞癌患者共226例的HPV基因分型资料进行回顾性分析,HPV基因检测采用人乳头瘤病毒核酸扩增分型检测试剂盒方法。结果226例患者年龄20~77(45.55±11.41)岁,196例VAIN患者年龄分布20~77(44.26±10.65)岁,30例阴道鳞癌患者年龄分布27~74(54.03±12.75)岁。VAIN与阴道鳞癌的整体年龄分布明显不同(P<0.01)。VAINⅠ、VAINⅡ、VAINⅢ、阴道壁癌分别占41.59%(94/226)、32.74%(74/226)、12.40%(28/226)和13.27%(30/226)。21种HPV型别有17种被检出,所有患者均未检出43、45、51及66型。VAIN及阴道鳞癌的HPV DNA检测结果阳性率达80.09%(181/226),高危型人乳头瘤病毒(hr-HPV)感染阳性率为90.06%(163/181),其中28例VAINⅢ及阴道鳞癌患者的hr-HPV DNA检测结果均为阳性;HPV 16型为引起阴道病变的主要亚型,占31.42%(71/226),其次为58型(14.60%,33/226)、33型(10.62%、24/226)、CP8304型(9.73%,22/226)及53型(7.52%,17/226)。在各级别病变中均存在HPV型别的混合感染,单重感染率随疾病的病变程度增加而呈递增趋势,阴道鳞癌标本中作为单重感染原的HPV型别有限。结论 HPV感染与VAIN及阴道鳞癌的发生发展有关,使用HPV DNA检测技术有助于筛查阴道病变。
Objective To investigate the clinical significance of cervical papillomavirus (HPV) in the distribution of vaginal intraepithelial neoplasia (VAIN) and vaginal squamous cell carcinoma (SAG) and its significance. Methods A total of 226 HPV genotyping data of VAIN and vaginal squamous cell carcinoma patients from Shengjing Hospital of China Medical University from January 2008 to December 2012 were analyzed retrospectively. The HPV gene was detected by PCR amplification of human papillomavirus Type test kit method. Results A total of 226 patients were aged 20-77 years (45.55 ± 11.41 years). The age distribution of 196 patients with VAIN was 20-77 (44.26 ± 10.65) years. The age distribution of 30 patients with vaginal squamous cell carcinoma was 27-74 (54.03 ± 12.75) years old. The overall age distribution of VAIN and vaginal squamous cell carcinoma was significantly different (P <0.01). VAINⅠ, VAINⅡ, VAINⅢ and vaginal wall cancer accounted for 41.59% (94/226), 32.74% (74/226), 12.40% (28/226) and 13.27% (30/226) respectively. Twenty-one of the 21 HPV types were detected, and none of the patients detected type 43, 45, 51 and 66. The positive rate of HPV DNA test in VAIN and vaginal squamous cell carcinoma was 80.09% (181/226), and the positive rate of high-risk human papillomavirus (HPV-HPV) infection was 90.06% (163/181), including 28 cases of VAINⅢ and vagina HPV-16 was the major subtype of vaginal lesions, accounting for 31.42% (71/226), followed by 58 (14.60%, 33/226), type 33 (10.62%, 24/226), CP8304 (9.73%, 22/226) and 53 (7.52%, 17/226). In all levels of lesions there are mixed types of HPV infection, single infection rate increases with the degree of disease lesions showed an increasing trend, vaginal squamous cell carcinoma specimens as a single source of original HPV type is limited. Conclusion HPV infection is associated with the occurrence and development of VAIN and vaginal squamous cell carcinoma. The use of HPV DNA detection technology is helpful for the screening of vaginal lesions.