宫颈鳞癌患者放化疗前后高危型人乳头状瘤病毒感染的变化  

Change of high-risk human papillomavirus infections in patients with cervical squamous cell carcinoma before and after chemoradiotherapy

作　　者：胡国志[1] 武英蕾[1] 肖颖[1] 杨宏[1] 李华[1] 

机构地区：[1]唐山市工人医院肿瘤科,河北唐山063000

出　　处：《中华医院感染学杂志》2015年第14期3309-3310,3322,共3页Chinese Journal of Nosocomiology

基　　金：河北省科技厅科技基金资助项目(5638HB-058)

摘　　要：目的研究高危型人乳头状瘤病毒(HPV)感染在宫颈鳞癌患者同步放化疗前后阳性率变化,以及对引发宫颈鳞癌的主要高危型HPV亚型的探讨。方法对2012年2月-2014年2月收治的278例患者按照数学随机抽选的方式选取94例进行同步放化疗,在治疗前后10个月,采集宫颈内脱落细胞并检测计算其高危型HPV的阳性率;在入院时已确诊为高危型HPV DNA阳性患者中随机抽选68例进行检测,分析其HPV亚型。结果94例患者中治疗前HPV-DNA阳性90例,其中高危型高达86例,阳性率为91.5%;在治疗后10个月的94例患者复查中,4例阴性患者无改变仍为阴性,而86例高危型HPV-DNA阳性患者中有71例转阴,余15例仍为阳性且为高危型,经过治疗后高危型HPV-DNA阳性率仅为16.0%;在68例高危型HPV-DNA阳性患者的检查中发现HPV16和HPV18较高,分别占72.0%和13.2%。结论经过宫颈鳞癌同步放化疗高危型HPV-DNA阳性率明显降低,HPV16是引发宫颈鳞癌的主要高危型HPV亚型。OBJECTIVE To study the change of the positive rate of high-risk human papillomavirus（HPV）infection in the patients with cervical squamous cell carcinoma before and after the concurrent chemoradiotherapy and explore the major subtypes of HPV that induce the cervical squamous cell carcinoma.METHODS Totally 94 patients were randomly extracted from 278 patients who were treated in the hospital from Feb 212 to Feb 2014 and were given the concurrent chemoradiotherapy.After the treatment for 10 months,the cervical exfoliated cells were collected to determine the positive rate of high-risk HPV,and 68 patients with conformed high-risk HPV-DNA at the admission to the hospital were randomly selected to analyze the subtypes of HPV.RESULTS Of the 94 patients,90cases were tested positive for HPV-DNA before the treatment,of whom 91.5%（86cases）were positive for the high-risk type.Ten months after the treatment,the reexamination of the 94 patients showed that 4negative cases remained negative,71 of 86with positive high-risk HPV-DNA turned into negative,and the rest of 15 cases remained positive for the high-risk type.The positive rate of the high-risk HPV-DNA was only 16.0%.Among the68 patients who were positive for the high-risk HPV-DNA,72.0% were tested positive for HPV16 and 13.2%were tested positive for HPV18.CONCLUSION The concurrent chemoradiotherapy can significantly reduce the positive rate of the high-risk HPV-DNA in the patients with cervical squamous cell carcinoma.The HPV16 is the predominant subtype of the high-risk HPV causing the cervical squamous cell carcinoma.

关 键 词：宫颈鳞癌 同步放化疗 高危型 人乳头状瘤病毒 

分 类 号：R181.32[医药卫生—流行病学]