高危型人乳头状瘤病毒病毒载量与宫颈癌临床病理因素关系的研究

Relationship between high-risk human papillomavirus viral load and clinical pathological factors of cervical cancer

目的 研究高危型人乳头状瘤病毒（HR-HPV）病毒载量与宫颈癌临床病理因素的关系.方法 选取初次治疗、经病理学检查诊断为宫颈癌患者97例,对HR-HPV病毒载量与宫颈癌临床病理因素的关系进行分析.结果 宫颈癌Ⅰ期患者（45例）HR-HPV病毒载量显著高于宫颈癌Ⅱ期（29例）、宫颈癌 ≥Ⅲ期（23例）患者[484.03（289.22,773.54）RLU/CO比88.24（53.15,133.30）和41.41（13.39,164.21）RLU/CO],差异有统计学意义（P〈0.05）;宫颈癌Ⅱ期患者与宫颈癌≥Ⅲ期患者比较差异无统计学意义（P〉0.05）.宫颈癌〈ⅡB期（48例）患者HR-HPV病毒载量明显高于宫颈癌≥ⅡB期患者（49例）[464.23（235.66,742.89）RLU/CO比61.87（22.85,138.82）RLU/CO],差异有统计学意义（P〈0.05）.将患者按HR-HPV病毒载量分为〉100 RLU/CO组（57例）和≤100 RLU/CO组（40例）,≤100 RLU/CO组宫颈癌≥ⅡB期比率明显高于〉100 RLU/CO组[75.0%（30/40）比33.3%（19/57）],差异有统计学意义（P〈0.01）.97例宫颈癌患者中,高分化9例、中分化58例、低分化19例、分化程度不清11例.去除分化程度不清患者,高中分化患者HR-HPV病毒载量明显高于低分化患者[173.56（62.76,523.92）RLU/CO比45.71（4.05,164.21）RLU/CO],差异有统计学意义（P〈0.05）.结论 HR-HPV病毒载量随宫颈癌临床分期及病理分级的进展而降低,提示其在宫颈癌进展中的作用可能不显著,低HR-HPV病毒载量在≥ⅡB期的宫颈癌中常见,可能提示低病毒载量是宫颈癌患者预后不良的指标之一.

Objective To study the relationship between high-risk human papillomavirus （HR- HPV） viral load and clinical pathological factors of cervical cancer. Methods Ninety- seven initial treatment patients with cervical cancer were selected, and they were diagnosed by pathological examination. The relationship was analyzed between HR-HPV viral load and clinical pathological factors of cervical cancer. Results The HR- HPV viral load in cervical cancer Ⅰ stage （45 cases） was significantly higher than that in cervical cancer Ⅱ stage （29 cases） and cervical cancer ≥Ⅲ stage （23 cases）：484.03 （289.22, 773.54） RLU/CO vs. 88.24 （53.15, 133.30） and 41.41 （13.39, 164.21） RLU/CO, and there was statistical difference （P〈0.05）; but there was no statistical difference between cervical cancerⅡstage and cervical cancer≥Ⅲstage （P〉0.05）. The HR-HPV viral load in cervical cancer〈ⅡB stage （48 cases） was significantly higher than that in cervical cancer ≥ⅡB stage （49 cases）： 464.23 （235.66, 742.89） RLU/CO vs. 61.87 （22.85, 138.82） RLU/CO, and there was statistical difference （P〈0.05）. The patients were divided into 〉100 RLU/CO group （57 cases） and ≤100 RLU/CO group （40 cases） according to the HR- HPV viral load. The rate of cervical cancer ≥ⅡB stage in ≤100 RLU/CO group was significantly higher than that in〉100 RLU/CO group：75.0%（30/40） vs. 33.3%（19/57）, and there was statistical difference （P〈0.01）. Among 97 patients with cervical cancer, well-differentiated was in 9 cases, moderately differentiated in 58 cases, poorly differentiated in 19 cases, and the degree of differentiation was not clear in 11 cases. The HR- HPV viral load in well and moderately differentiated patients was significantly higher than that in poorly differentiated patients： 173.56 （62.76, 523.92） RLU/CO vs. 45.71 （4.05, 164.21） RLU/CO, and there was statistical difference （P〈0.05）. Conclusions The HR-HPV viral load is decreased with the progression of cervical cancer clinical staging and pathological grading. It shows that HR-HPV viral load in the progression of cervical cancer is not obvious. Lower HR-HPV viral load is common in cervical cancer≥ⅡB stage. It may indicate that low viral load is one of the indicators of poor prognosis in patients with cervical cancer.