HPV分型及血清肿瘤标志物在宫颈癌诊断中的临床意义  

The significance of HPV typing and the tumor markers in cervical cancers

作　　者：邱峰 黄匡 唐虹 徐建华 

机构地区：[1]广州中医药大学第二附属医院检验科,广州510120 [2]广东省江门市新会区妇女儿童医院检验科,529100 [3]广州中医药大学第二附属医院妇科,广州510120

出　　处：《检验医学与临床》2017年第14期2011-2013,2016,共4页Laboratory Medicine and Clinic

基　　金：广东省科技厅科技计划资助项目(2014A020212681);广东省中医药管理局资助项目(20161099);广东省广州市科技计划项目(201510010044)

摘　　要：目的探讨人乳头瘤病毒(HPV)分型及血清肿瘤标志物糖类抗原125(CA125)、癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC-Ag)在不同程度宫颈病变和宫颈癌的临床意义。方法收集72例健康者和296例不同宫颈疾病类型的患者,检测患者血清CA125、CEA、SCC-Ag水平;分析176例HPV阳性患者的亚型在不同程度宫颈病变及宫颈癌的分布情况,探讨相关性。结果 (1)患者中炎性组血清CA125水平明显高于其他各组(P<0.01),宫颈癌组血清CEA、SCC-Ag水平明显高于其他各组(P<0.05)。(2)176例HPV阳性标本共检出22种亚型,其中检出频次较高的5种HPV亚型依次为HPV52型58例(33.0%),HPV16型47例(26.7%),HPV58型22例(12.5%),HPV39型14例(8.0%),HPV35型12例(6.8%)。不同程度的宫颈病变及宫颈癌HPV亚型分布不同,HPV16、52、58、39亚型在不同程度宫颈病变的分布差异有统计学意义(HPV16/52/39:P<0.01;HPV58:P<0.05)。(3)5种常见HPV亚型与宫颈病变的相关性:HPV16感染率与宫颈病变严重程度呈正相关(R2=0.445,P<0.01),HPV52呈负相关(R2=―0.401,P<0.01);其余各亚型与宫颈病变严重程度均无相关性(P>0.05)。结论宫颈癌患者血清CEA和SCC-Ag升高;HPV分型可能与宫颈病变相关。Objective To analyze the changes of human papilloma virus（HPV） typing and three serological tumor markers CA125,carcinoembryonic antigen（CEA） and squamous cell carcinoma antigen（SCC-Ag） in cervical lesions of various degrees and cervical cancers.Methods A total of 72 healthy subjects and 296 cases of patients with various cervical diseases were collected,and CA125,CEA and SCC-Ag in patients with cervical lesions of various degrees were detected.For 176 case of positive HPV patients,the distribution of HPV infection subtypes in cervical lesions of various degrees and cervical cancers was counted to analyze the correlation.Results （1）For patients with cervical lesions of various degrees and cervical cancers,the serum CA125 level was significantly higher in the inflammation group than that in other groups（P〈0.01）,CEA,SCC-Ag in cervical cancers were higher than those in other groups（P〈0.05）.（2） Altogether 22 subtypes were detected among the 176 cases of positive HPV patient samples,5 most frequently detected HPV subtypes were HPV52（58 cases,33.0%）,HPV16（47 cases,26.7%）,HPV58（22 cases,12.5%）,HPV39（14 cases,8.0%）,and HPV35（12 cases,6.8%） successively.The distribution of HPV subtypes varied in cervical lesions of various degrees and cervical cancers,the subtypes HPV16,HPV52,HPV58 and HPV39 showed notable differences in cervical lesions of various degrees（HPV16/52/39：P〈0.01;HPV58：P〈0.05）.（3） It could be figured out through analyzing the correlation among 5 common HPV subtype infection and cervical lesions of various degrees that HPV16 infection increased with the increase in cervical lesion severity（R2=0.445,P〈0.01）,while HPV52 infection decreased with the increase in cervical lesion severity（R2=-0.401,P〈0.01）,and the remaining HPV subtype infection showed no distinct correlation with the cervical lesion severity（P〉0.05）.Conclusion Changes of the serum CEA and SCC-Ag levels are rising in the serum of cervical cancer;HPV typing may be as

关 键 词：宫颈癌 人乳头瘤病毒分型 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤]