宫颈癌患者原发灶及盆腔淋巴结中人乳头瘤病毒感染状况及其与宫颈癌复发的关系  

Human papillomavirus infection in primary lesions and pelvic lymph nodes in patients with cervical cancer and its relationship with cervical cancer recrudescence

作　　者：王彤[1] 刘先明[2] 王澜 杨梅[1] WANG Tong;LIU Xian-ming;WANG Lan;YANG Mei(Department of Gynecology,Jiangyou People's Hospital,Jiangyou 621700,China;Department of Pathology,Jiangyou People's Hospital,Jiangyou 621700,China)

机构地区：[1]四川省江油市人民医院妇科,江油市621700 [2]四川省江油市人民医院病理科,江油市621700

出　　处：《广西医学》2020年第22期2939-2942,共4页Guangxi Medical Journal

摘　　要：目的分析宫颈癌患者宫颈病变组织和盆腔淋巴结中人乳头瘤病毒(HPV)感染状况及其与宫颈癌复发的关系。方法回顾性分析98例宫颈癌患者的临床病理资料,共98份宫颈组织标本和228份盆腔淋巴结标本(包括47个转移性淋巴结和181个非转移性淋巴结)。分析宫颈癌患者原发灶组织、盆腔转移性和非转移性淋巴结中HPV阳性率及分型,以及影响宫颈癌复发的因素。结果宫颈癌患者原发灶以及盆腔转移性淋巴结、非转移性淋巴结中HPV-DNA阳性率分别97.96%、81.25%、70.17%,最常见的类型均为高危型HPV16、HPV18。98例患者中,失访4例,随访期间复发19例,发生远处转移死亡3例。国际妇产科联合会分期高、淋巴结旁血管浸润、宫颈癌原发灶HPV16阳性均是宫颈癌复发的危险因素(均P<0.05),而宫颈癌组织中HPV18阳性以及盆腔淋巴结中HPV16、HPV18阳性与宫颈癌复发无相关性(均P>0.05)。结论宫颈癌患者原发灶和相应淋巴结中HPV阳性率均较高,均以高危型HPV最为常见。宫颈癌患者原发病灶HPV16阳性或可用于预测宫颈癌的复发,而盆腔淋巴结中的常见高危型HPV可能与宫颈癌复发无关。Objective To analyze human papillomavirus(HPV)infection in cervical lesions and pelvic lymph nodes in patients with cervical cancer and its relationship with cervical cancer recrudescence.Methods The clinicopathological data of 98 patients with cervical cancer were retrospectively analyzed,involving 98 samples of cervical tissues and 228 samples of pelvic lymph nodes(consisting of 47 metastatic lymph nodes and 181 non-metastatic lymph nodes).The positive rate and type of HPV in primary lesions,metastatic lymph nodes and non-metastatic lymph nodes as well as the factors influencing recrudescence of cervical cancer were analyzed in cervical cancer patients.Results Among patients with cervical cancer,primary lesions,metastatic lymph nodes and non-metastatic lymph nodes yielded positive HPV-DNA rates of 97.96%,81.25% and 70.17%,respectively,all with high-risk HPV16 and HPV18 as the most common type.Among the 98 patients,loss to follow-up occurred in four cases,recrudescence during follow-up in 19 cases,and death due to distant metastasis in three cases.Higher International Federation of Gynecology and Obstetrics stage,lymphovascular space invasion,and HPV16-positive in primary lesions of cervical cancer were the risk factors for recrudescence of cervical cancer(all P<0.05),whereas HPV18-positive in cervical cancer tissues and HPV16/HPV18-positive in pelvic lymph nodes were not related to recrudescence of cervical cancer(all P>0.05).Conclusion In patients with cervical cancer,either primary lesions or corresponding lymph nodes exhibit a relatively high HPV positive rate,and high-risk HPV is the most common type.In patients with cervical cancer,HPV16-positive in primary lesions may be applied to predicting recrudescence of cervical cancer,however,the common type of high-risk HPV in pelvic lymph nodes may has no correlation with recrudescence of cervical cancer.

关 键 词：宫颈癌 人乳头瘤病毒 原发灶 盆腔淋巴结 复发 

分 类 号：R737.33[医药卫生—肿瘤]