高危型HPV载量及IFNγ基因多态性与LEEP术后CIN患者预后的相关性

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摘要目的：探讨高危型人乳头状瘤病毒（HPV）载量及γ干扰素（IFNγ）基因多态性与宫颈上皮内瘤变（CIN）患者经环状电圈切除（LEEP）术后病灶残留或复发的关系，以及发病过程中的相关性。方法：所选来自本院门诊或住院行LEEP术的HPV阳性患者共439例，并选取同期体检HPV阴性的健康女性120例作为对照，采用基因测序方法检测IFNγ基因多态性，术后3、6、9、12个月时复查高危型HPV DNA及宫颈新柏氏液基细胞学（TCT）检测。结果：IFNγ基因多态性rs243056l位点TT基因型为HPV感染发病的保护因素（OR为0.471，95%CI：0.283～0.783；x2=8.702；P=0.003），AA基因型为HPV感染发病的危险因素（OR为1.688，95%CI：1.108～2.572；x2=6.005；P=0.014），术前及术后3个月HPV载量与病灶残留/复发相关（P＜0.05）。Kaplan-Meier分析结果显示，AA与TT基因型HPV感染累积阴性率有显著差异（log-rank=15.414，P＜0.001），AA基因型女性HPV感染的累积阴性率最低，病灶残留/复发率为45.65%。结论：术前及术后3个月高危型HPV载量与CIN的发生、进展及CIN患者LEEP术预后有关。IFNγ基因rs2430561位点多态性影响女性宫颈HPV的易感性，AA基因型女性感染风险更高，并易于HPV感染的持续和复发。

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	陈艳
	林琳
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关键词 ：宫颈上皮内瘤样病变；&gamma, 干扰素基因多态性；乳头状瘤病毒；病毒负荷量

Abstract：Objective: To investigate the association of interferon-gamma gene polymorphisms and the correlation between viral load remains and recidivation after loop ment for CIN patients. Methods: Performed gene analysis was used for detection of polymorphisms in interferon-gamma gene in 439 HPV positive patients undergone the LEEP treatment for CIN and 120 HPV negative normal controls, reviewed high-risk HPV DNA and cervix uterus TCT were reviewed in 3, 6, 9 and 12 months after treatment. Results: That the individuals with the TT genotype showed statistically significant had protection against HPV infection (OR=0.471, 95%CI=0.283～0.783; x2=8.702, P=0.003). That the individuals with the AA genotype showed statistically significant increased risk for HPV infection (OR=1.688, 95%CI=1.108～2.572; x2=6.005, P=0.014). The viral load before and after 3 months LEEP treatment of high-risk HPV was a risk factor of remains or recidivation after LEEP treatment (P<0.05). In the analysis of Kaplan-Meier, the cumulative HPV negative rates of AA and TT genotype exhibited significantly different (log-rank=15.414, P<0.001). The cumulative HPV negative rate of AA genotype was the lowest, the remains or recidivation rate of AA genotype was 45.65%. Conclusion: The viral load before and after 3 months LEEP treatment of high-risk HPV is related to CIN and the prognosis for CIN patients. Interferon-gamma gene rs2430561 polymorphisms affects the susceptibility to HPV infection. Women with AA genotype exhibited higher risk of infection and inclined to be continuous status and recurrence after HPV infection.

Key words： cervical intra-epithelial neoplasia interferon-gamma gene polymorphism human papilloma virus viral load

收稿日期: 2015-01-12

基金资助:瑞安市科技计划项目（201102060）。

作者简介: 陈艳（1980-），女，浙江瑞安人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I10 /738

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