Analysis of human papillomavirus infection status in cervical lesions / 肿瘤研究与临床

ABSTRACT

Objective:To investigate the occurrence of human papillomavirus (HPV) single and multiple infections in different cervical lesions, and to analyze the distribution of HPV types in patients with single infection and the change of viral load before and after treatment.Methods:A total of 4 783 HPV-DNA-positive cases who were detected by cervical exfoliated cells HPV-DNA testing from May 2017 to March 2019 in Shanxi Provincial People's Hospital were retrospectively analyzed, of which 3 728 cases met the criteria and were included in this study. Fluorescence quantitative polymerase chain reaction (PCR) was used to determine HPV genotype and viral load, and liquid-based thin-layer cytology (TCT) test and colposcopic histopathological diagnosis were performed. According to the histopathological results, the patients were divided into chronic cervicitis+cervical intraepithelial neoplasia (CIN) Ⅰ group, CIN Ⅱ+CIN Ⅲ group and cervical cancer group.Results:A total of 3 364 cases had HPV single infection, of which chronic cervicitis+CIN Ⅰ accounted for 78.27% (2 633/3 364), CIN Ⅱ+CIN Ⅲ accounted for 18.73% (630/3 364), and cervical cancer accounted for 3.00% (101/3 364); 364 cases had HPV multiple infections, of which chronic cervicitis+CIN Ⅰ accounted for 51.65% (188/364), CIN Ⅱ+CIN Ⅲ accounted for 42.58% (155/364), and cervical cancer accounted for 5.77% (21/364). The difference in the proportion of cervical lesions with different pathological grades in HPV single infection and multiple infections was statistically significant ( χ2 = 127.21, P < 0.01). The top four HPV single infection genotypes in chronic cervicitis+CINⅠ group and CINⅡ+CINⅢ group were type 16, 52, 58 and 53, and their proportions were 17.05% (449/2 633), 12.91% (340/2 633), 9.08% (239/2 633) and 8.89% (234/2 633) in chronic cervicitis+CINⅠ group, and 32.22% (203/630), 10.32% (65/630), 8.41% (53/630) and 5.87% (37/630) in CINⅡ+CINⅢ group. In the cervical cancer group, the top two HPV single infection genotypes were type 16 and 18, and their proportions were 81.19% (82/101) and 6.93% (7/101). The viral load of 120 patients with HPV infection was 4.89±1.14 before treatment and 2.86±1.63 after treatment, and the difference was statistically significant ( t = 13.260, P < 0.01). Conclusions:HPV multiple infections are more likely to aggravate the degree of cervical lesions than single infection. Common HPV infection subtypes in different cervical lesions include type 16, 52, 58, 53 and 18.