HPV多重感染与宫颈癌患者临床病理学特征分析

Analysis of the Relationship between Multiple HPV Infections and Clinicopathologic Characteristics in Patients with Uterine Cervical Cancer

目的:对宫颈癌患者中HPV感染率及型别分布进行研究,探讨宫颈癌患者HPV多重感染与临床病理特征的关系。方法:选取2008年9月至2009年4月浙江省肿瘤医院因宫颈癌就诊且有临床病理确诊的患者171例,采用导流杂交基因芯片技术对HPV感染进行基因诊断和分型,并进一步比较HPV多重感染、单一感染、无感染者在年龄、临床分期、病理类型和淋巴结转移上的差异。结果:171例宫颈癌患者中HPV感染者为122例(71.35%),其中单一感染者103例(60.2%)、多重感染者19例(11.1%);HPV多重感染中以二重感染最常见(15例)、三重感染及四重感染各2例。单一感染主要是HPV16、18、58,多重感染主要是HPV16+58/52。无论是单一感染还是多重感染,均以含HPV16为主要的感染型别。年龄≥52岁宫颈癌患者中HPV多重感染的比例明显高于.<52岁患者,且两者存在显著性差异(P<0.05)。在临床分期、病理分型及淋巴结转移上,HPV多重感染与单一感染或无感染者之间均无差异。结论:HPV多重感染与宫颈癌患者年龄有关,但与临床分期、病理类型、淋巴结转移等预后因子均无关系,可能是独立的预后预测因子。导流杂交基因芯片技术适合临床筛查HPV感染及对HPV进行基因分型。

Objective： Human papillomavirus （ HPV ） has become a point of interest in studies of oncogenic viruses. Over 200 genotypes of HPV have been found. However, the genotypic distribution in uterine cervix cancer （UCC） remains unknown. The aim of this study was to investigate the infection rate of HPV and genotype distributions in UCC, and to discuss the relationship between multiple HPV infections and clinicopathological features in UCC patients. Methods： The HPV genotypes were detected in 171 UCC patients treated in Zhejiang Provincial Cancer Hospital between September 2008 and April 2009. The genetic diagnosis and HPV genotyping were conducted using flow-through hybridization and gene chip technology （ HybriMax ）. The difference among the age, clinical stages, clinicopathologic types and nodal metastasis in the patients with multiple, single and absent HPV infection were compared and analyzed. Results： HPV infection was found in 122 of 171 （ 71.35 %, 122/171 ） UCC patients, of which 103 （ 60.2 %, 103/171 ） had single HPV infection and 19 （ 11.1%, 19/171 ） had multiple infections. Dual infection was the most common of the multiple HPV infections and was found in 15 patients; triple infection was found in 2 patients and quadruple infection was found in another 2 patients. HPV16, HPV18 and HPV58 were the most common types of single infection, and HPV16＋HPV58 and HPV16＋HPV52 were most frequently seen in multiple HPV infections. HPV16 was the major type of HPV infection both in the multiply and singly infected patients. The ratio of multiple HPV infection was higher in the patients aged ≥ 52 years than in those 〈 52, with significant differences between the two groups （ P 〈 0.05 ）. However, there were no differences in clinical staging, pathologic type, and nodal metastasis among patients with multiple and single infections or those without HPV infection. Conclusion： HPV multiple infection status is related to age but is not related to other prognostic indicators such as clinical stage, pathological type, or lymph node metastasis. HybriMax flow-through hybridization and gene chip technology is suited to clinical screening for HPV infection and genotype.