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学科主题: 妇产科学
题名:
宫颈病变组织中HPV病毒载量与病变程度关系
作者: 沈媛媛
答辩日期: 2016-05-12
导师: 吴瑞芳
专业: 妇产科学
授予单位: 北京大学
授予地点: 北京大学深圳医院
学位: 博士
关键词: 人乳头瘤病毒,病毒载量,病毒亚型,石蜡包埋宫颈病变组织
其他题名: he Relationship Between the HPV Viral Load and the Degree of Pathology in the Cervical Lesions
分类号: R737.33
摘要:

目的:高危型人乳头瘤病毒(high-risk human papilloma virus, HR--HPV)载量与癌前病变进展的关系以及HPV载量与病毒清除关系的研究仍存在争议。本文针对石蜡包埋宫颈病变组织(cervical lesion embedded in paraffin  CLPE)中HPV病毒载量的研究,探讨各级别宫颈病变的病灶组织中不同亚型HPV病毒载量与子宫颈癌发生的相关关系。

方法:选择病理诊断明确的CINⅠ、CINⅡ、CINⅢ与子宫颈癌各20例之石蜡包埋的宫颈活检或LEEP手术切除标本。每个病例4~12个蜡块,共计458个蜡块。所有蜡块均重新切片,由两位高年资病理医生按照子宫颈病变的诊断标准阅片,确定诊断。

采用微切技术获取其石蜡包埋宫颈病变组织(CLPE)中病灶细胞,以荧光定量PCR技术进行人乳头瘤病毒亚型检测。同时采用HPV核酸分型定量分析软件,通过看家基因与待测细胞的线性关系获得HPV亚型在单位细胞内的病毒载量。分析各级别宫颈病变病灶组织中HPV亚型病毒载量,探讨其在发病中的作用。

结果:1.宫颈病灶中HPV亚型检出率在CINⅠ、CINⅡ、CIN Ⅲ与子宫颈癌分别为88%、100%、100%和100%。HPV亚型在不同级别病变的分布不同,HPV16亚型在CINⅢ/子宫颈癌阳性率(85%)明显高于CINⅡ(46%)与CINⅠ(47%,P<0.05);HPV52亚型在CINⅠ、CINⅡ、CINⅢ中检出频率相当;HPV58亚型则在低度病变检出频度为高。2.单位CLPE内HPV病毒载量随病变程度增加而升高(P<0.05),亚型阳性频率占前三位的HPV16、52、58三种亚型单位CLPE内的病毒载量在宫颈高度病变明显高于低度病(P<0.05)。3.HPV多重感染在CINⅠ、CINⅡ、CINⅢ与子宫颈癌分别为47.1%、21.4%、50.0%和26.7%,多重感染与病变的严重程度未显示明显的相关性。

结论:宫颈病灶组织中HPV16、52、58亚型与宫颈病变密切相关,病变单位细胞内的HPV病毒载量随宫颈病变程度增加而升高。

英文摘要:

Objective

The relationship between high risk human papillomavirus viral load and precancerous lesion progress,and the relationship between thigh risk human papillomavirus viral load and HPV clearance still remain controversial. The aim of this study is to explore the relationship between HPV subtype viral load and cervical cancer by investigating the different subtypes of HPV viral load in various grades of cervical lesions embedded in paraffin (CLPE).

Method

All of 80 cases diagnosed by definite pathology were divided into four groups CINⅠ, CINⅡ, CIN Ⅲ and ICC,each group including 20 cases. These samples came from cervical biopsy or LEEP. There are 4 to 12 wax blocks in each case, with a total of 458 blocks. All the paraffin blocks were re-sliced, and the diagnosis was made by two senior doctors according to the diagnostic criteria of cervical lesions.

The focus cells in CLPE were obtained by Using micro - cutting technique. The human papillomavirus subtypes were detected by fluorescence quantitative PCR technique. Meanwhile, the HPV viral load in the unit cells was obtained by HPV nucleic acid quantitative analysis software according to the linear relationship of housekeeping genes and tested cell. The study investigate the effect of viral load in the pathogenesis of cervical lesions, by analyzing the HPV subtype viral load in different degree of cervical lesions

 

 

Result

The relevance ratio of HPV subtype in CINⅠ,CINⅡ,CIN Ⅲ and cervical cancer was 88%, 100%,100%,and 100% respectively. Different HPV subtypes have various distribution in the different grades of cervical lesions .The positive rate of HPV16 subtype in CINⅢ/ cancer (85%) was significantly higher than that in the CINⅡ (46%) and CINI (47%, P<0.05). The frequency of HPV52 in CIN Ⅰ, CIN Ⅱand CIN Ⅲ was basically consistent. HPV58 were found to have a high frequency in the low degree of the disease.

The HPV viral load within unit CLPE increased with the aggravated cervical lesion (P < 0.05).The positive frequency of the top three is HPV16, 52, 58. The viral load within unit the CLPE of high grade lesion was significantly higher than that of low grade lesions (P<0.05).

 HPV multiple infection in CINⅠ, CINⅡ, CIN Ⅲ and cervical cancer were 47.1%, 21.4%%, 50% and 26.7% respectively. The correlation between multiple infections and the severity of the cervical lesions did not show.

Conclusion

HPV16, 52, 58 subtypes were closely related to cervical lesions. The HPV viral load in the diseased cell increased with the degree of cervical lesions.

语种: 中文
相关网址: 查看原文
内容类型: 学位论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/125371
Appears in Collections:北京大学深圳医院_学位论文

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作者单位: 北京大学深圳医院

Recommended Citation:
沈媛媛. 宫颈病变组织中HPV病毒载量与病变程度关系[D]. 北京大学深圳医院. 北京大学. 2016.
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