膀胱移行细胞癌HPV-16/18感染的相关临床病理特征分析  

Analysis of the Relationship of Clinico-pathological Character of Transitional Cell Carcinoma with HPV-16/18 Infection in Urinary Bladder

作　　者：吕宁[1] 郑闪[1] 肖泽均[1] 林冬梅[1] 何祖根[1] 

机构地区：[1]中国协和医科大学中国医学科学院肿瘤医院肿瘤研究所,100021

出　　处：《实用癌症杂志》2003年第6期561-564,共4页The Practical Journal of Cancer

基　　金：国家自然科学基金资助 (39370 2 91 )

摘　　要：目的　研究膀胱移行细胞癌 (TCC)人乳头瘤病毒 16/18(HPV 16/18)感染的相关临床病理特征。方法　采用PCR法检测 12 3例膀胱TCC组织中HPV 16/18DNA感染情况 ,采用双盲法阅片确定病理特征 ,并收集包括肿瘤数目及术后无瘤生存期在内相关的临床资料 ,应用SPSS 10 .0软件分析所得实验结果。结果　 12 3例TCC组织中HPV 16/18DNA总阳性率达 5 9.3 %( 73 /12 3 ) ,7例正常对照组织内未见有HPV 16/18感染 ,两者有非常显著性差异 ( χ2 =7.2 ,P <0 .0 1) ;TCC多发率为 19.5 % ( 2 4/12 3 ) ,乳头状和浸润性生长为其主要生长方式 ,肿瘤组织内鳞状分化率为 8.9% ( 11/12 3 ) ,凹空细胞出现率为 43 .1% ( 5 3 /12 3 ) ,HPV 16/18DNA仅与凹空细胞出现相关 ( χ2 =18.4,P <0 .0 1) ;Kaplan Meier生存曲线分析发现仅病理分期是独立的预后因子 ,HPV 16/18DNA存在与术后无瘤生存期无关。结论　HPV 16/18感染可能与膀胱TCC发生相关 ;凹空细胞的出现可为提示HPV 16/18感染的指标 ,用于临床诊断有待进一步研究 ;Objective To investigate the relationship of clinico-pathological features of transitional cell carcinoma(TCC) with human papillomavirus-16/18(HPV-16/18) infection in the urinary bladder.Methods HPV-16/18 DNA was detected by Polymerase chain reaction(PCR) in 123 specimens of TCC.Slides with H&E stains were examined by three pathologists separately to determined growth pattern,pathological grade,pathological stage,malignant squamous metaplasia and occurrence of the kiolocyte.The clinical data,like the number of tumor,follow-up data and so on,were also collected.SPSS 10.0 was used to analyse all data.Results The positive rate of HPV-16/18 DNA was 59.3%(73/123) in TCC and there was no infection of HPV-16/18 in normal control(χ 2=7.2,P<0.01).19.5%(24/123) of the cases had more than one tumor and papillary and invasive pattern were the two major growth pattern.The rate of malignant squamous metaplasia was 8.9%(11/123),and the occurrence rate of koilocytes was 43.1%(53/123).Koilocytes may be positively related to the infection of HPV-16/18(P<0.01).Kaplan-Meier survival curve analysis showed that only pathological stage was the independent prognosis factor,and that HPV-16/18 DNA had no relationship with disease-free survival time.Conclusion The infection of HPV-16/18 may be related to the carcinogenesis of TCC of the urinary bladder.The koilocytes may be one of the morphologic markers of the infection of HPV-16/18 in TCC and the value in clinical diagnosis needs further research.Pathological stage is an independent prognosis factor.

关 键 词：膀胱移行细胞癌 HPV-16/18感染 病理 人乳头瘤病毒 

分 类 号：R737.14[医药卫生—肿瘤]