人乳头瘤病毒与子宫颈腺癌病因关系研究  

Distribution of human papillomavirus （HPV） among HPV positive cervical adenocarcinoma cases detected by laser capture microdissection （LCM）

作　　者：刘彬[1] 吴泽妮 刘潇阳[2] 孙海魁[1] 李青[2] 林春青[1] 曾亮[3] 崔剑峰[1] 于晓红[4] 张询[2] 李凌[2] 陈汶[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院流行病学研究室,100021 [2]中国医学科学院北京协和医学院肿瘤医院病理科,100021 [3]湖南省肿瘤医院病理科,长沙410006 [4]江西省妇幼保健院病理科,南昌330000

出　　处：《中华肿瘤杂志》2016年第4期277-282,共6页Chinese Journal of Oncology

摘　　要：目的：分析人乳头瘤病毒（ HPV）阳性的子宫颈腺癌组织经显微切割后HPV型别的分布状况。方法收集2005—2010年全国7个不同地区9所三级甲等医院诊断为宫颈腺癌的病理组织，进行三明治切片，对全蜡卷和显微切割后的病灶组织进行HPV分型检测，采用HE 染色和免疫组化进行病理诊断。结果 HPV阳性的宫颈腺癌标本169例，其中颈管型腺癌94例，腺鳞癌9例，微小偏离型腺癌19例，透明细胞腺癌14例，宫内膜样型腺癌8例，浆液性腺癌9例，未分型腺癌16例。全蜡卷共检测了14种高危型HPV型别，感染率最高为HPV16，其次为HPV18和HPV52。与全蜡卷比较，显微切割后HPV阳性率有不同程度降低，不同病理类型宫颈腺癌显微切割后HPV阳性率差异有统计学意义（P＜0．001）。单一感染和多重感染显微切割后HPV阳性率分别为50．8％和66．7％，差异无统计学意义（P＝0．14）。不同病理类型宫颈腺癌组织中p16的阳性率差异有统计学意义（P＜0．001）。显微切割后HPV阳性和阴性患者的p16阳性率分别为73．9％和38．5％，差异有统计学意义（ P＜0．001）。结论显微切割技术能够更精确地了解和评价宫颈腺癌中的HPV感染及分布状况，宫颈腺癌的发生与HPV感染的关系不是十分密切。Objective To investigate the distribution of human papillomavirus （ HPV ） in the diseased areas cut from HPV-positive cervical adenocarcinoma （ ADC ） detected by laser capture microdissection （ LCM ） . Methods Paraffin-embedded specimens diagnosed as ADC between 2005 and 2010 were collected from 9 hospitals in 7 regions across China. HPV genotyping was conducted on paraffin sections using sandwich technique and LCM in order to identify HPV infection in the tumor tissues. HE and p16 immunohistochemistry staining were performed to make histological diagnosis. Results A total of 169 cervical adenocarcinoma cases were recruited, including 94 cases of mucinous adenocarcinoma （ ADC-CX） , 9 cases of adenosquamous carcinoma （ ASC） , 19 cases of minimal deviation adenocarcinoma （ ADC-MIN） , 14 cases of clear cell adenocarcinoma （ ADC-CC） , 8 cases of endometrioid adenocarcinoma （ ADC-ENDO） , 9 cases of serous adenocarcinoma （ ADC-SER ） and 16 cases of adenocarcinoma not otherwise specified （ADC-NOS）. Fourteen types of high risk HPV were detected in the whole tissue section （WTS）. HPV16 was the most common type, and the second was HPV18 and HPV52, respectively. Compared with WTS, the HPV-positive rate detected by LCM was lower. The HPV positive rates were significantly different among different subtypes of cervical adenocarcinoma （ P〈0.001） . After LCM, the HPV positive rate was 50.8% and 66.7% in the single infection and multiple, infection groups respectively （P=0.14）. The positive rates of＆amp;nbsp;p16 was significantly different among different subtypes of cervical adenocarcinoma （ P〈0.001） . p16-positive rate was 73. 9% in the HPV-positive samples after LCM, significantly higher than the 38. 5% of negative samples （ P〈0.001） . Conclusions Laser capture dissection technique can more precisely reflect the HPV distribution in cervical adenocarcinomas. The etiological association between HPV infection and cervical adenocarcinoma occurrence is not as close

关 键 词：人乳头瘤病毒 宫颈肿瘤 激光捕获显微切割 免疫组织化学 

分 类 号：R737.33[医药卫生—肿瘤]