盆腔淋巴结HPV16/18DNA检测在宫颈癌的应用

Application of HPV16/18 DNA detection in pelvic lymph node in cervical carcinoma

目的探讨宫颈癌患者盆腔淋巴结高危型人乳头状瘤病毒16/18(HPV16/18)DNA检出情况与宫颈癌临床病理特征的相关性,同时探讨宫颈癌原发灶和盆腔淋巴结组织中HPVDNA检出的相关性及意义。方法采用前瞻性研究方法,收集鄂州市中心医院自2011年1月至2012年6月间收治的行宫颈癌根治术患者的石蜡标本,采用聚合酶链反应(PCR)方法,检测33例宫颈癌组织及115枚盆腔淋巴结组织中HPV16/18 DNA。结果 33例宫颈癌患者中盆腔淋巴结HPV16/18阳性检出率为54.55%(18/33),其阳性检出率与临床分期、有无淋巴结转移、病理分化程度、肌层浸润深度、有无宫体及阴道侵犯有关,差异均有统计学意义(x^2值分别为9.528、5.241、10.481、7.187、3.915、7.274,均P<0.05)。宫颈癌组织HPV16/18阳性检出率为72.73%(24/33),与盆腔淋巴结HPV16/18阳性检出率进行相关分析,二者呈正相关(r=0.398,P<0.05)。淋巴结转移组与淋巴结未转移组总淋巴结个数的HPV16/18阳性检出率进行比较,差异有统计学意义(x^2=36.449,P<0.05)。结论检测盆腔淋巴结有助于发现早期隐匿性转移,HPV可以作为检测微转移的特异性标志物。

Objective To explore the correlation between detection of high-risk type human papilloma virus 16/18 （HPV16/18） DNA in pelvic lymph node in patients with cervical carcinoma and clinicopathologic features, and to investigate the correlation and clinical significance of primary cervical cancer focus and HPVDNA in pelvic lymph node. Methods With prospective study method, patients undergoing radical hysterectomy of cervical carcinoma in Ezhou Center Hospital from January 2011 to June 2012 were recruited. Polymerase chain reaction （PCR） was adopted to test cervical cancer tissues of 33 cases and HPV16/18 DNA in 115 pieces of pelvic lymph node. Results The positive detection rate of pelvic lymph node HPV16/18 in 33 cases was 54.55% （18/33）, and it was correlated with clinical stage, lymph node metastasis, pathology differentiation degree, muscle layer infiltration depth, corpus and vaginal infiltration. The differences had statistical significance （χ2 value was 9. 528, 5. 241, 10. 481,7. 187, 3. 915 and 7. 274, respectively, all P 〈0.05）. The positive detection rate of HPV16/18 in cervical carcinoma tissue was 72.73% （24/33）, and it was positively correlated with that of pelvic lymph node HPV16/18 （r =0. 398, P 〈0.05）. The positive detection rate of HPV16/18 of the total number in lymph node metastasis group and the group without lymph node metastasis was statistically different （χ2 = 36. 449, P 〈 0.05）. Conclusion Detecting pelvic lymph node is helpful to detect early occult metastases, and HPV can be used as specific marker of micro transfer.