喉鳞状细胞癌及癌前病变的HPV感染亚型分析及临床意义

Subtype analysis and clinical significance of HPV infection in laryngeal squamous cell carcinoma and precancerous lesions

目的:探讨喉鳞状细胞癌和癌前病变与HPV感染亚型的相关性及可能的临床关系。方法:取31例喉鳞状细胞癌、52例癌前病变(29例声带白斑和23例喉乳头状瘤)患者的组织石蜡包埋标本切片,采用核酸分子水平的快速导流杂交基因芯片分型技术,进行37种HPV亚型检测和分型;以36例声带息肉组织作为对照组。结果:喉鳞状细胞癌组中HPV总阳性率为19.4%(6/31),声带白斑组中HPV总阳性率为0,喉乳头状瘤组中HPV总阳性率为65.2%(15/23),对照组均为阴性。HPV感染阳性的喉鳞状细胞癌标本中检出的HPV病毒均为高危型HPV16亚型;HPV感染阳性的喉乳头状瘤标本中共检出HPV病毒有6个HPV亚型分布(3例HPV16,2例HPV45,4例HPV52,1例HPV18,8例HPV6,1例HPV11);个体有2种或多种亚型混合感染。HPV感染与喉鳞状细胞癌及癌前病变患者的性别及其高、低危亚型分布差异无明显统计学意义。结论:喉鳞状细胞癌和癌前病变的发生与HPV感染相关,但与高、低危亚型分布无明显相关性;HPV检测对临床筛查喉癌和癌前病变及HPV特定亚型疫苗的研制具有积极意义。

Objective：To investigate the correlation of laryngeal squamous cell carcinoma （LSCC） and precan- cerous lesion with HPV infection subtypes and possible clinical relationship. Method： Eighty-three cases in paraffin embedded tissues were detected with thirty seven HPV subtypes by flow-through hybridization and gene chip （Hy- briMax） ,including 31 cases of laryngeal squamous cell carcinoma, 52 cases of precancerous lesions （29 cases of vo- cal cord leukoplakia and 23 cases of laryngeal papilloma）, and 36 cases of vocal cord polyp as normal vocal mucosa were used as control. Result：The total positive rate of HPV was 19.4% in the group of laryngeal squamous cell carcinoma （6/31）, 0 in vocal cord leukoplakia, 65.2% in laryngeal papilloma （15/23）, and the control group were all negative, HPV virus subtype of HPV-positive laryngeal squamous cell carcinoma were all high-risk HPV16; and there were 6 HPV virus subtypes in laryngeal papilloma （8： HPV6,4： HPV52, 1： HPVll, 1： HPV18, 2： HPV45, 3： HPV16）,individual mixing two or more subtypes infection. HPV infection of laryngeal squamous cell carcinoma and precancerous lesions has no statistically significant difference according to gender, high low-risk subtypes. Conclusion： HPV infection related to laryngeal squamous cell carcinoma and precancerous lesions, but no significant correlation with the subtype distribution of high and low risk; HPV detection is making positive sense to clinical diagnosis of laryngeal carcinoma and precancerous lesions as well as the development of specific HPV subtype vaccine.