HR-HPV检测在宫颈癌同步放化疗疗效评估中的作用

The role of HR-HPV detection in assess the efficacy of concurrent chemoradiotherapy of cervical cancer

目的分析宫颈癌同步放化疗后高危型人乳头瘤病毒（HR-HPV）清除情况,探讨HR-HPV检测在评价宫颈癌近期疗效中的意义。方法回顾性研究2010年1月~2013年10月在我院接受根治性放化疗的宫颈鳞癌患者共104例,治疗前HR-HPV均为阳性,FIGO分期为ⅠB~ⅢB期,采用第二代杂交捕获实验（HC2）,于放疗结束后3、6个月分别进行HR-HPV检测,分析HR-HPV在评价宫颈癌同步放化疗后近期疗效的价值。结果入组病例中,HR-HPV自然清除81例,持续感染23例,放化疗后HR-HPV的阳性率明显低于治疗前;HR-HPV持续感染人群中病变残留和复发率为17.4%,高于HR-HPV转阴性组。HR-HPV阳性组与阴性组复发率比较,差异有统计学意义（P〈0.05）。结论在宫颈癌同步放化疗后,HR-HPV的清除率较高,HR-HPV持续感染与病变残留或复发密切相关。

Objective To analyze the clear situation of high-risk human papilloma virus（HR-HPV） after chemoradiotherapy of cervical cancer,and to explore the significance of HR-HPV detection in evaluating the effect of cervical cancer in the near future. Methods From January 2010 to October 2013, 104 patients of cervical squamous carcinoma who were treated with concurrent chemoradiotherapy were analyzed retrospectively. In all cases, The HR-HPV were positive before the treatment, FIGO staging ⅠB-ⅢB, the HR-HPV was detected at 3 and 6 months respectively after the chemoradiotherapy by the second-generation hybrid capture experiment（HC2）, and the value of HR-HPV detection in cervical cancer in the near future curative effect after chemoradiotherapy were evaluated. Results In all cases, HRHPV disappeared in 81 cases, 23 cases were persistent infection, the positive rate of HR-HPV infection was significant lower after chemoradiotherapy than before treatment; the local residual/recurrence rate was 17.4% in HR-HPV positive groups, higher than the HR-HPV negative groups. and the recurrence rate was statistically significant between two groups（P〈0.05）. Conclusion In cervical cancer after concurrent chemoradiotherapy, HR-HPV clearance rate is higher, HR-HPV persistent infection is closely related to the the residual or recurrence of disease.