HPV感染对卵巢癌患者调强适形放疗同步化疗治疗后临床疗效及预后的影响

Effects of HPV infection on clinical curative effect and prognosis of patients with ovarian cancer after intensity modulated radiation therapy and chemotherapy

目的探究人乳头瘤病毒(HPV)感染对卵巢癌患者调强适形放疗同步化疗治疗后临床疗效及预后的影响。方法选取2016年5月-2017年5月在三门峡市中心医院治疗的卵巢癌患者179例,均给予调强适形放疗同步化疗治疗,根据治疗前HPV感染情况将其分为HPV感染组(n=93)和未感染组(n=86)。分析两组患者临床资料;比较两组治疗总有效率;比较两组3年生存率、死亡率;采用Kaplan-meier法对生存资料进行描述,并采用Logrank检验对生存曲线进行比较;分析HPV感染与调强适形放疗同步化疗治疗疗效及患者治疗后3年生存情况的相关性;采用多元Logistics回归分析影响患者治疗后3年生存情况的危险因素。结果卵巢癌患者179例,HPV感染93例,感染率为51.96%。HPV感染组临床分期Ⅲ~Ⅳ、淋巴结转移人数比例高于未感染组,差异有统计学意义(P<0.05)。HPV感染组总缓解率(86.02%)低于未感染组(95.35%),差异有统计学意义(P<0.05);HPV感染与总缓解率呈负相关(r=-0.159,P=0.034),与总获益率无相关性(r=-0.070,P=0.354)。HPV感染组3年生存率(47.31%)低于未感染组(67.44%),死亡率(52.69%)高于未感染组(32.56%),差异均有统计学意义(P<0.05);HPV感染组的中位生存时间为34.9个月;HPV感染与患者治疗后3年生存率呈负相关(r=-0.203,P=0.006)。临床分期Ⅲ~Ⅳ、淋巴结转移、HPV感染是影响患者治疗后3年生存情况的危险因素(P<0.05)。结论HPV感染会导致卵巢癌患者调强适形放疗同步化疗治疗疗效降低,3年死亡率升高,且HPV感染是影响患者治疗后3年生存情况的危险因素。

Objective To explore the effects of human papilloma virus(HPV)infection on clinical curative effect and prognosis of patients with ovarian cancer after intensity modulated radiation therapy(IMRT)and chemotherapy.Methods A total of 179 patients with ovarian cancer who were treated in Sanmenxia Central Hospital from May 2016 to May 2017 were enrolled.All were treated with IMRT and chemotherapy.According to different HPV infection situations before treatment,they were divided into HPV infection group(n=93)and non-infection group(n=86).The clinical data in both groups were analyzed.The total response rate of treatment and 3-year survival rate,mortalities were compared between the two groups.The survival data were described by Kaplan-meier method.The survival curves were compared by Log-rank test.The correlation between HPV infection and curative effect after IMRT and chemotherapy,and survival situations at 3 year after treatment were analyzed.The risk factors that affected the survival situations at 3-year after treatment were analyzed by multivariate Logistics regression analysis.Results Of the 179 ovarian cancer patients,there were 93 cases(51.96%)with HPV infection.The proportions of patients with clinical staging at stageⅢ~Ⅳand lymph node metastasis in HPV infection group was higher than that in non-infection group(P<0.05),while overall remission rate was lower than that in non-infection group(86.02%vs.95.35%)(P<0.05).HPV infection was negatively correlated with overall remission rate(r=-0.159,P=0.034),while not related to overall benefit rate(r=-0.070,P=0.354).The 3-year survival rate in HPV infection group was lower than that in non-infection group(47.31%vs.67.44%),while mortality was higher than that in non-infection group(52.69%vs.32.56%)(P<0.05).The median survival time in HVP infection group was 34.9 months.HPV infection was negatively correlated with 3-year survival rate after treatment(r=-0.203,P=0.006).Clinical staging at stageⅢ~Ⅳ,lymph node metastasis and HPV infection were risk factors of 3-year survival situations after treatment(P<0.05).Conclusions HPV infection decreased the curative effect of IMRT and chemotherapy on patients with ovarian cancer while increased 3-year mortality.HPV infection was a risk factor of 3-year survival situations after treatment.