HPV亚型对喉磷状细胞癌及癌前病变的定性诊断价值

Diagnostic value of HPV subtype on laryngeal squamous cell carcinoma and precancerous lesion

目的探讨人乳头状瘤病毒(HPV)感染亚型与喉鳞状细胞癌及癌前病变的相关性及临床诊断价值。方法选取喉鳞状细胞癌39例,癌前病变48例(包括声带白斑22例和喉乳头状瘤26例)患者的组织标本石蜡切片,以38例声带息肉组织为对照组,采用PCR基因扩增和DNA反向点杂交DNA芯片技术,检测样本中HPV DNA表达及分型。结果喉鳞状细胞癌组HPV感染率高于声带白斑组和对照组,喉乳头状瘤组HPV感染率高于喉鳞状细胞组、声带白斑组和对照组,差异均有统计学意义(P<0.05)。喉鳞状细胞癌HPV阳性患者其高危亚型HPV16的发生率显著高于喉乳头状瘤,其低危亚型HPV6型发生率显著低于喉乳头状瘤,差异均有统计学意义(P<0.05);两组患者的HPV33型和HPV11型发生率差异无统计学意义(P>0.05)。喉鳞状细胞癌组和喉乳头状瘤组男性和女性HPV感染阳性率比较差异均无统计学意义(P>0.05);男性喉乳头状瘤患者HPV感染率(73.33%)高于男性喉鳞状细胞癌患者(31.03%),差异有统计学意义(P<0.05);而女性喉乳头状瘤患者与喉鳞状细胞癌患者的HPV感染率比较差异无统计学意义(P>0.05)。结论 HPV感染与喉鳞状细胞癌和癌前病变显著相关,检测HPV亚型分布对喉癌的针对性防治及特定疫苗研发有重要临床意义。

Objective To analyze the clinical diagnostic value of human papilloma virus（HPV） subtype on laryngeal squamous cell carcinoma and precancerous lesion. Methods 39 patients with laryngeal carcinoma,48 patients of precancerous lesions including 22 cases of vocal cord leukoplakia and 26 cases of laryngeal papilloma,were detected by DNA chip technology combining polymerase chain reaction（PCR）with DNA reverse point hybrid. Results The HPV infection rate of laryngeal squamous carcinoma group was higher than that in the vocal cord leukoplakia group and control group,and the rate of laryngeal papilloma group was higher than that in the laryngeal squamous carcinoma group,the vocal leukoplakia group and the control group,the differences were statistically significant（P〈0.05）. The high risk subtype HPV16 infection rate of patients with HPV positive in the laryngeal squamous carcinoma group was significantly higher than that of laryngeal papilloma group,and the low risk subtype HPV6 infection rate was significantly lower than that in the laryngeal papilloma group,the differences were statistically significant（P〈0.05）. There was no statistical difference of subtype HPV33 and HPV11 infection rate between the two groups（P〈0.05）. The HPV positive rates of the laryngeal squamous carcinoma group and laryngeal papilloma group between the male patients and female patients showed no statistical difference（P〉0.05）. The HPV infection rate of male patients in the laryngeal squamous carcinoma group was 73.33%,which was higher than that of male patients in the laryngeal papilloma group of 31.03%,the difference was statistically significant（P〈0.05）. However,the HPV infection rate of female patients with laryngeal papilloma and laryngeal squamous cell carcinoma patients showed no significant difference（P〉0.05）. Conclusions HPV infection was closely related with laryngeal squamous cell carcinoma and precancerous lesions,the HPV detection has a high value for clinical diagnosis of laryngeal carcinoma and precancerous lesions,and the development of specific HPV subtype vaccine is worth promoting.