HPV16基因联合细胞角蛋白对宫颈鳞癌淋巴结微转移检测的意义

Significance of HPV16 DNA and cytokeratin in detecting lymph node micrometastasis of cervical squamous cell carcinoma

目的探讨高危型人类乳头状瘤病毒16(HPV16)和细胞角蛋白(cyto keratin,CK)对宫颈鳞癌淋巴结微转移的诊断价值。方法以HPV16 E6/E7特异引物通过PCR方法,检测81例宫颈鳞癌组织及435枚盆腔淋巴结中HPV16DNA;采用免疫组化SP法检测上述组织中CK的表达。结果①宫颈鳞癌组织中HPV16的检出率为62.96%(51/81);CK的表达率为100%(81/81)。②HE染色有转移的淋巴结中,HPV16阳性检出率为90.38%(47/52),CK阳性表达率为100%(52/52);HE染色无转移的淋巴结中,HPV16阳性检出率为11.75%(45/383),CK阳性表达率为7.05%(27/383)。③盆腔淋巴结中HPV16存在和CK表达与患者的FIGO分期、年龄、宫颈肌层浸润深度、宫颈肿瘤大小、大体类型、肿瘤分化程度等临床病理特征均无相关性(P>0.05)。结论宫颈鳞癌中HE染色无转移的淋巴结内存在HPV16基因和CK阳性表达可以提示淋巴结微转移。

Objective To study the roles of human papillomavirus （HPV） type 16 DNA and cytokeratin （CK） in diagnosing lymph nodes micrometastasis in cervical squamous cell carcinoma. Methods HPV16 DNA was detected by polymerase chain reaction using HPV16 E6/E7 type-specific primers and the expression of CK was analyzed by irnmunohistochemistry in 81 primary tumors and 435 local lymph nodes from 81 patients with cervical squarnous cancer. Results ①The positive rates of HPV16 DNA and CK in patients with primary cervical squarnous cancer were 62.96% and 100%, respectively. ②The positive rate of HPV16 DNA and expression rate of CK in metastatic pelvic lymph nodes were high （90.38 % and 100%, respectively）. In lymph nodes without metastasis, they were low （ 11.75 % and 7.05 %, respectively）. Lymph node micrometastasis had no significant correlation with FIGO stage, age, depth of cervical infiltration, tumor size, gross type of cervical lesion and tumor histological grade （P 〉 0.05 ）. Conclusion Detection of CK and oncogenic HPV16 DNA in lymph nodes without metastasis can indicate that there is lymph node micrometastasis in cervical squamous neoplasm.