宫颈癌患者淋巴结HPV16/18感染及血清鳞状细胞癌抗原检测的临床意义

The clinical significance of detection of HPV 16/18 in lymph nodes and squamous cell carcinoma antigen level in serum of cervical carcinoma patients

目的:探讨宫颈癌患者淋巴结HPV16/18感染及术前血清鳞状细胞癌抗原(SCCA)水平与临床病理参数的相关性,以及宫颈分泌物及淋巴结中HPV16/18感染和术前血清SCCA水平三者之间的关系。方法:采用实时荧光定量PCR法检测35例宫颈癌患者的宫颈分泌物及淋巴结HPV16/18阳性率,同时用ELISA法检测术前血清SCCA水平。结果:宫颈癌患者宫颈分泌物及淋巴结HPV16/18阳性率分别为80%(28/35)和20%(7/35)。7例组织学阳性淋巴结及28例阴性淋巴结HPV16/18阳性率分别为85.71%(6/7)和3.57%(1/28)。SCCA阳性率为37.14%(13/35)。淋巴结HPV16/18阳性感染与术前SCCA水平相关(r=0.650,P<0.01),两者均与淋巴结转移、间质浸润深度及脉管累及有关(P<0.05),而和宫颈分泌物HPV16/18阳性感染无关(P>0.05)。结论:HPV16/18在组织学阳性淋巴结中感染率高,与宫颈癌患者淋巴结转移密切相关。而阴性淋巴结中的HPV16/18检出提示微转移。术前SCCA水平与淋巴结转移相关。

Objective：To investigate HPV16/18 infection in lymph nodes in cervical carcinoma and the relationship among preoperative serum level of squamous cell carcinoma antigen（SCCA）,HPV16/18 infection in cervical secretion and pathological parameters. Methods：We detected the positive rate of HPV16/18 in lymph nodes and secretion of 35 cervical carcinoma patients by real-time quantitative polymerase chain reaction.Preoperative serum SCCA was detected by Enzyme-linked immunosorbent assay.Results：The positive rate of HPV16/18 in cervical secretion was 80%（28/35） and that in lymph nodes was 20%（7/35）.The positive rate of HPV16/18 in lymph nodes with metastases was 85.71%（6/7）as compared with that of 3.57%（1/28） in the other patients without metastases.The positive rate of serum SCCA was 37.14%（13/35）.HPV16/18 in positive lymph nodes was related to preoperative serum SCCA（r=0.650,P0.01）.Both HPV16/18 positive in lymph nodes and SCCA were associated with lymph-node metastasis,depth of stromal invasion and lymph-vascular space invasion（P0.05）.There were no statistical relationship between HPV16/18 in lymph nodes,preoperative level of SCCA and HPV16/18 in cervical secretion.Conclusions：A high infection rate of HPV16/18 in positive lymph nodes and preoperative SCCA are closely retlated to lymph-node metastasis in cervical carcinoma patients,while the detection of HPV16/18 in negative nodes may be an indication for tumor micrometastasis.