高危型HPV在宫颈癌前哨淋巴结微转移中的研究

High-risk HPV in Cervical Cancer Advanced Post Lymph Node Micro Shift Research

目的通过检测早期宫颈癌患者前哨淋巴结中的高危型HPV16/18的表达,探讨高危型HPV16/18与早期宫颈癌前哨淋巴结微转移的相关性及其临床意义。方法选择Ia2-Πa期宫颈癌患者42例;所有的患者均行广泛性子宫切除加双侧盆腔淋巴结清扫术;采用放射性核素联合亚甲蓝方法识别宫颈癌患者前哨淋巴结;应用聚合酶链反应(polymerase chain re-action,PCR)方法,检测早期宫颈癌患者前哨淋巴结中HPV16/18DNA的表达,计数资料采用χ2检验。结果 42例宫颈癌患者共检出82枚前哨淋巴结。用常规病理组织学方法检测有11枚前哨淋巴结有癌转移,阳性率为13.4%(11/82);经PCR法检测有26枚HPV16/18表达阳性,阳性率为31.7%(26/82)。病理阳性淋巴结经PCR法检测HPV16/18的表达均阳性。病理组织学证实无癌转移的71枚前哨淋巴结,经PCR方法检测有15枚HPV16/18表达阳性,阳性率为21.3%(15/71)。结论与传统的病理组织学比较,采用PCR法检测宫颈癌前哨淋巴结中HPV16/18的表达能显著提高微转移的检出率。HPV可作为检测宫颈癌微转移的特异性标志物。

Objective Through the early detection of cervical cancer sentinel lymph node in patients with high - risk type hpvl6/ 18 expression to explore the high - risk type hpvl6/18 with early stage cervical cancer sentinel lymph node micro - metastasis and its clinical significance. Methods Choice Ia2 - Ha time cervical cancer patient 42 examples ;. All patient good universality womb excision adds the two - sided pelvic cavity lymph to sweep clear the technique cleanly. Uses the radionuelide union methylene blue method rec- ognition cervical cancer patient advanced post lymph node. Application of polymerase chain reaction（ polymerase chain reaction, PCR） method in the Sentinel lymph node detection in patients with cervical cancer expression of HPV16/18DNA, count data using the X2 test. Results The 42 cases of cervical cancer Sentinel lymph node in patients with a total of 82. Detected by routine histopathologieal methods 11 sentinel lymph node metastasis, the positive rate was 13.4% （11/82） ; by PC R assay 26 HPV16/18 express positive, posi- five rate was 31.7% （26/82）. Pathologically positive lymph nodes by pet method detection hpvl6/18 expression are positive. The his- topathology confirmed the metastasis of 71 sentinel lymph node detection by PCR method,there are 15 pieces of hpvl6/18 positive ex- pression, the positive rate was 21.3% （15/71）. Conclusion Comparison with traditional histopathology ,using pet method detection of cervical cancer sentinel lymph node hpvl6/18 of expression can significantly improve the detection rate of micro - metastasis. HPV can be a specific marker of micro - metastasis as the detection of cervical cancer.