HPV感染负荷量及HPV-E6蛋白表达预测宫颈癌新辅助化疗效果的价值

Association of human papillomavirus infection load and the effect of neoadjuvant chemotherapy on cervical cancer patients

目的研究宫颈癌患者人乳头瘤病毒（HPV）感染负荷量及宫颈癌组织HPV-E6蛋白表达与新辅助化疗效果的相关性,探讨其预测宫颈癌化疗效果的可能性。方法收集云南省肿瘤医院2010年6月~2011年12月收治的40例宫颈癌患者,对其进行新辅助化疗1~3个疗程,化疗结束后4周评价治疗效果;化疗前采用二代杂交捕获技术（hc2HPV DNA）检测HPV负荷量,免疫组化MaxVision法检测宫颈癌组织HPV-E6蛋白表达,研究化疗效果与化疗前HPV负荷量、HPV-E6蛋白表达的关系。结果新辅助化疗临床有效率为85%。宫颈鳞癌患者HPV感染负荷量为466.78±695.48,显著高于腺癌患者的277.78±167.72（P〈0.05）。化疗有效组HPV感染负荷量为472.40±726.62,显著低于化疗无效组的1 969.68±32.19,宫颈癌患者HPV感染负荷量与新辅助化疗效果呈负相关（P〈0.05）。宫颈癌组织HPV-E6蛋白表达与宫颈癌病理类型、分期、HPV负荷量及新辅助化疗疗效均无相关性（P〉0.05）。结论 HPV感染负荷量与宫颈癌新辅助化疗效果有关,其负荷量越大化疗效果越差,通过宫颈癌患者HPV负荷量可有效预测宫颈癌新辅助化疗效果。

Objective To study the association between the human papillomavirus （HPV） infection load, HPV-E6 protein expression level and the effects of neoadjuvant chemotherapy on cervical cancer pa- tients. Methods A total of 40 cervical cancer patients in the Cancer Hospital of Yunnan province from June 2010 to December 2011 were treated with 1-3 cycles of neoadjuvant chemotherapy and the therapeutic effects were evaluated 4 weeks after the treatment was completed. Prior to chemotherapy, the HPV infection load and HPV-E6 protein expression were measured by the second generation hybrid capture （hc2 HPV DNA） and im- munohistochemical method （MaxVision）, respectively. Results The effective rate of neoadjuvant chemother- apy was 85 %. The HPV infection load in cervical squamous carcinoma patients were 466.78±695.48, which is significantly higher than that in adenocarcinoma patients （277.78±167.72） （P〈0.05） . The HPV infec- tion load in patients with effective neoadjuvant chemotherapy was 472.40± 726.62, which is markedly lower than that in the noneffective group （1969.68± 32.19） （P〈0.05） . No significant difference was found be- tween the expression of HPV-E6 protein, the pathological type, stage and the effect of neoadjuvant chemo- therapy. Conclusions HPV infection load was related to the effect of neoadjuvant chemotherapy in cervical cancer patients. The higher the HPV load, the worse the effect of neoadjuvant chemotherapy.