子宫内膜组织人乳头瘤病毒感染的初步研究

Study on human papilloma virus infection in endometrium

目的了解正常子宫内膜,宫颈癌患者子宫内膜以及子宫内膜癌组织HPV感染情况。方法选择HPVL1区改良通用型引物Gp5+/Gp6+,通过HPV-DNA扩增和DNA测序法,对2004年9月～2006年3月我院妇科收治的25例宫颈癌、30例子宫内膜癌患者的石蜡包埋组织进行HPV检测,以20例子宫肌瘤患者作为对照组。每例宫颈癌取癌组织及正常子宫内膜;每例内膜癌取癌组织及正常宫颈粘膜;每例子宫肌瘤取正常子宫内膜及宫颈粘膜。结果①25例宫颈癌病例中,16例宫颈癌组织及1例子宫内膜组织检测出HPV感染。这例子宫内膜与其相应的宫颈癌组织均为HPV-16型感染;②30例子宫内膜癌组织及其相应的宫颈粘膜组织均未检测出HPV-DNA,检出率均为0(0/30);③对照组正常子宫内膜及宫颈粘膜均未检出HPV-DNA,检出率均为0(0/20)。结论①子宫内膜HPV感染很少,说明其可能不是HPV复制、成熟的适宜宿主组织;②宫颈癌患者子宫内膜组织的HPV可能由上行感染所致,但感染率较低;③子宫内膜癌的发生、发展可能与HPV无关。

Objective To investigate human papilloma virus （HPV） infection in normal endometrium, endometrium from the cervical cancer and endometrial carcinoma. Methods By the PCR - based method using L1 modified general primers （GP5＋/GP6＋） and sequencing of the PCR product, we detected 25 pairs of paraffinembedded tissues from cervical cancers and 30 pairs from endometrial carcinomas. Both cancer tissues and normal endometrium of each cervical cancer case were collected as one pair. Carcinoma tissues and its normal cervical mucosa from each endometrial carcinoma case were considered as one pair. Normal endometrium and cervical mucosa from 20 patients with uterine myomas were as control. Results （1） HPV was detected in 16 cervical cancer tissues and 1 endometrium specimen among the 25 pairs of cervical cancers. This pair of endometrium and cervical cancer tissues both presented positive HPV - 16. （2） No HPV was detected in 30 pairs of specimens from endometrial carcinomas （0/30）. （3） No HPV-DNA was detected in the controls, neither endometrium nor cervical mucosa （0/20）. Conclusions （1） HPV being hardly detected in endometrium indicates endometrium is not the suitable host of HPV replication and maturation. （2） HPV in cervical cancer tissues is likely to up spread from uterine cervix to endometrium, but this is rare. （3） HPV infection seems not related to pathogenesis and transformation process of endometrial carcinoma.