云南省3000例妇女宫颈人乳头瘤病毒的检测与基因分型

doi:10.3877/cma.j.issn.1673-5250.2012.05.003

中华妇幼临床医学杂志(电子版) ›› 2012, Vol. 08 ›› Issue (05) : 568 -572. doi: 10.3877/cma.j.issn.1673-5250.2012.05.003

所属专题：经典病例；文献；

论著

云南省3000例妇女宫颈人乳头瘤病毒的检测与基因分型

岳耀斐¹, 杨丽娟¹, 陈俊英¹, 潘岳¹, 赵玉娇¹, 孙强明¹^,^*^,^*(

)

^1. 650118　昆明，中国医学科学院北京协和医学院医学生物学研究所　云南省重大传染病疫苗研发重点实验室

收稿日期:2012-07-12 修回日期:2012-08-28 出版日期:2012-10-01
通信作者: 孙强明

Genetic Subtypes and Distribution of Human Papillomavirus in Yunnan Province: Report of 3000 Cases

Yao-fei YUE¹, Li-juan YANG¹, Jun-ying CHEN¹, Yue PAN¹, Yu-jiao ZHAO¹, Qiang-ming SUN¹()

^1. Institute of Medical Biology, Peking Union of Medical College, Chinese Academy of Medical Science, Kunming 650118, Yunnan Province, China

Received:2012-07-12 Revised:2012-08-28 Published:2012-10-01
Corresponding author: Qiang-ming SUN
About author:
(Corresponding author: SUN Qiang-ming, Email: qmsun1972@yahoo.com.cn)

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岳耀斐, 杨丽娟, 陈俊英, 潘岳, 赵玉娇, 孙强明. 云南省3000例妇女宫颈人乳头瘤病毒的检测与基因分型[J/OL]. 中华妇幼临床医学杂志(电子版), 2012, 08(05): 568-572.

Yao-fei YUE, Li-juan YANG, Jun-ying CHEN, Yue PAN, Yu-jiao ZHAO, Qiang-ming SUN. Genetic Subtypes and Distribution of Human Papillomavirus in Yunnan Province: Report of 3000 Cases[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2012, 08(05): 568-572.

目的

探讨云南省妇女宫颈人乳头瘤病毒(HPV)感染状况、亚型及年龄分布，为该地区预防HPV感染和防治宫颈癌提供科学依据。

方法

收集2010年7月至2011年12月云南省各地市州县送检至昆明医学院第一附属医院及于该院妇产科门诊就诊并自愿接受宫颈HPV检查者宫颈标本3000例为研究对象，年龄为18～75岁。通过提取HPV DNA后，通过巢式PCR，美国国立生物技术信息中心(NCBI)BLAST序列比对等方法分析HPV－DNA亚型、感染率和年龄分布(本研究遵循的程序符合中国医学科学院北京和医学院医学生物学研究所人体试验委员会制定的伦理学标准，得到该委员会批准)。

结果

自3000例受试对象中，共计检出646例HPV呈阳性者，感染率为21.53%。其中高危型HPV(HR－HPV)为476例(73.68%，476/646)，以HPV－16(33.59%，217/646)，－58(22.45%，145/646)，－33(8.51%，55/646)为主；低危型HPV(LR－HPV)为170例(26.32%，170/646)，以HPV－6(12.54%，81/646)，－81(7.74%，50/646)，－11(4.43%，28/646)为主。HPV感染的高峰年龄为29～39岁(44.27%，286/646)。

结论

HPV基因亚型分布具有一定地域性，云南省妇女宫颈HPV感染最常见类型为HPV－16，－58，－6。HPV－DNA分型检测在宫颈癌的临床诊断和预后方面具有重要意义。

关键词: 人乳头瘤病毒, 巢式PCR, 测序, 基因分型

Objective

To investigate the infection rate, genotypes and age distribution of human papillomavirus (HPV) in Yunnan Province.

Methods

From July 2010 to July 2011, a total of 3000 cervical specimens of outpatients from First Affiliated Hospital of Kunming Medical University were included into this study. After DNA extraction and amplification, genetic subtypes were analyzed by nested PCR and NCBI BLAST. The age distribution was also analyzed. Informed consent was obtained form all participates.

Results

A total of 646 cases out of 3000 were HPV-positive, with the positive rate of 21.53%. Among 646 HPV-positive samples, high risk HPV (HR-HPV) were 476 cases (73.68%, 476/646), and the top three subtypes were HPV-16 (33.59%, 217/646), -58 (22.45%, 145/646), -33 (8.51%, 55/646); low risk HPV (LR-HPV) were 170 cases (26.32%, 170/646), and the top three subtypes were HPV-6 (12.54%, 81/646), -81 (7.74%, 50/646), -11 (4.43%, 28/646). The peak ages of HPV infection was 29- to 39-year old.

Conclusions

The most common HPV subtypes in Yunnan Province among female reproductive tract infection were HPV-16, -58, -6. The detection of HPV- DNA is of great importance in diagnosis and prognosis of cervical cancer.

Key words: human papillomavirus, nested PCR, sequencing, genotype

图1 部分临床样本PCR扩增产物的电泳图

Figure 1 The electrophoretogram of PCR amplification products of part clinical samples(a：以β－globin引物扩增后得到110 bp条带；b：以引物MY09/MY11扩增获得的产物，条带几乎看不清；c：以图1b　产物为模板，GP5/GP6为引物扩增后获得的150 bp条带)

表1 HPV感染者亚型分布情况[n(%)]

Table 1 The distribution of human papillomavirus subtypes[n(%)]

类型		n(%)
HR－HPV		?
?	HPV－16	217(33.59)
?	HPV－58	145(22.45)
?	HPV－33	55 (8.51)
?	HPV－35	24 (3.72)
?	HPV－18	16 (2.48)
?	HPV－31	11 (1.70)
?	HPV－59	3 (0.46)
?	HPV－66	3 (0.46)
LR－HPV		?
?	HPV－6	81(12.54)
?	HPV－81	50 (7.74)
?	HPV－11	28 (4.43)
?	HPV－43	10 (1.52)
?	HPV－42	1 (0.15)

表1 HPV感染者亚型分布情况[n(%)]

Table 1 The distribution of human papillomavirus subtypes[n(%)]

类型		n(%)
HR－HPV		?
?	HPV－16	217(33.59)
?	HPV－58	145(22.45)
?	HPV－33	55 (8.51)
?	HPV－35	24 (3.72)
?	HPV－18	16 (2.48)
?	HPV－31	11 (1.70)
?	HPV－59	3 (0.46)
?	HPV－66	3 (0.46)
LR－HPV		?
?	HPV－6	81(12.54)
?	HPV－81	50 (7.74)
?	HPV－11	28 (4.43)
?	HPV－43	10 (1.52)
?	HPV－42	1 (0.15)

表2 云南省HPV感染者年龄分布情况

Table 2 The age distribution of human papillomavirus in Yunnan Province

年龄(岁)	n(%)
18～28	89(13.78)
29～39	286(44.27)
40～50	196(30.34)
51～61	49 (7.59)
62～72	7 (1.08)
73～83	2 (0.31)
不详	17 (2.63)

表2 云南省HPV感染者年龄分布情况

Table 2 The age distribution of human papillomavirus in Yunnan Province

年龄(岁)	n(%)
18～28	89(13.78)
29～39	286(44.27)
40～50	196(30.34)
51～61	49 (7.59)
62～72	7 (1.08)
73～83	2 (0.31)
不详	17 (2.63)

图2 HPV感染年龄分布直方图

Figure 2 The age distribution of human papilloma virus in histogram

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