子宫颈癌患者血清、盆腔淋巴结HPV检测及其相关性探讨

摘要

Objective: To investigate the associations and clinical significance of human papillomavirus ( HPV)DNA and HPV subtypes in primary lesions,serum and paraffin embedded pelvic lymph nodes of cervical carcinoma.Methods : Sixteen primary tumors , peripheral blood and paraffin embedded pelvic lymph nodes were collected from patients with cervical carcinoma who underwent radical hysterectomy and pelvic lymph nodes dissections.PCR was employed to examine HPV DNA and subtypes in the above specimens.Results: Among the 16 primary tumon and serum , we detected 8 HPV DNA positive samples ( 8/16.50％ ).13 of 16 (13/16, 81.25％ ) paraffin embedded pelvic lymph nodes were showed HPV DNA positive,60 lymph nodes were positive among the total 133 excisional lymph nodes ( 60/133 , 45.1％ ) , and the subtypes were almost identical with that in their corresponding primary tumors.Remarkably, we found that in embedded pelvic lymph nodea was higher 45.1％ ( 60/133) than the lymph node metastasis rate detected by pathological diagnosia1.5％ ( 2/133) .Notably , 6 patients( 6/16 ,37.5％ ) were observed HPV DNA positive of primary tumors, serum and paraffin embedded pelvic lymph nodes;2 palients(2/16,12.5％ )were observed HPV DNA positive of primary tumors and paraffin embedded pelvic lymph nodea, while the serum was negatjye; 1 patient( 1/16, 6.25％ ) was observed HPV DNA positive of paraffin embedded pelvic lymph nodes and serum, while the primary tumors were negative;no patient was obsewed HPV DNA positive of primary tumors and senun ,but paraffin embedded pelvie lymph nodes were negative.The subtypes of HPV DNA positives were identical within the same patients.Conclusion: HPV DNA detective rate in serum uncorrelated with clinical stage.Compared with traditional pathology method, detection of HPV in pelvic lymph nodes may improve the detection rate of lymph node metastasis in cervical carcinoma, and the HPV DNA detection rate correlate with differentiated degree of the primary lesions .The infection of HPV in primary lesions , serum and paraffin embedded pelvic lymph nodes of cervical carcinoma may correlated.%目的:检测宫颈癌患者原发灶、血清及其盆腔淋巴结中HPV DNA及亚型,探讨其相关性及临床意义.方法:选取16例行广泛全子宫切除术和盆腔淋巴结清扫术宫颈癌患者的原发灶组织、术前静脉血与盆腔淋巴结石蜡组织,运用PCR方法对上述标本进行HPV DNA及亚型的检测.结果:宫颈癌原发灶组织、血清标本中HPV DNA阳性率为50% (8/16). 16例盆腔淋巴结石蜡组织中13例为HPV DNA阳性 (13/16, 81.25%),其中总共切除的133个淋巴结中60个为阳性(60/133,45.1%),8例淋巴结HPV DNA阳性的病例其对应的原发灶组织也为阳性且两者亚型相同.盆腔淋巴结中的HPV DNA阳性率为45.1%(60/133),显著高于病理证实的淋巴结转移率1.5%(2/133).6例患者(6/16,37.5%)原发灶、血清、盆腔淋巴结同时均为HPV DNA阳性;2例患者(2/16,12.5%)原发灶、盆腔淋巴结中HPV DNA表达阳性,而血清为阴性;1例患者(1/16,6.25%)淋巴结、血清HPV DNA阳性,而原发灶为阴性;未发现原发灶、血清HPV DNA表达阳性而淋巴结为阴性的病例,而且以上HPV DNA阳性的病例同一个患者对应的HPV亚型也相同.结论:宫颈癌患者血清中HPV DNA检出率与临床分期无关.宫颈癌患者盆腔淋巴结的HPV DNA检测可提高病理诊断淋巴结转移的阳性率,并且淋巴结中HPV DNA的检出率与原发灶的分化程度相关.宫颈癌原发灶、血清、盆腔淋巴结中HPV感染可能存在相关性.