人乳头瘤病毒16型E6癌基因对宫颈癌患者远期预后的影响

The prognostic impact of HPV16-E6-DNA expression on cervical carcinoma patients

目的研究人乳头瘤病毒16型E6癌基因(HPV16-E6-DNA)在宫颈癌组织中的水平及其与宫颈癌患者远期预后的关系。方法通过严格的纳入、排除标准筛选出84例宫颈癌患者,提取病理切片组织中DNA,构建HPV16-E6-DNA的质粒,采用qPCR法测定宫颈癌组织中HPV16-E6-DNA的水平。探究宫颈癌HPV16-E6-DNA病毒载量和其临床特征之间的关系采用Spearman相关性分析。通过kaplanMeier法、单因素分析对4年总生存率进行统计、比较。用Cox回归模型对宫颈癌患者的预后进行多因素分析。结果 Spearman相关性分析结果显示,年龄、FIGO分期、宫旁浸润、淋巴结转移与HPV16-E6-DNA病毒载量相关(P<0.05);组织学分化程度、病理类型、肿瘤直径、病灶类型、深肌层浸润情况与HPV16-E6-DNA病毒载量无明显相关(P>0.05)。单因素分析显示,HPV16-E6-DNA病毒载量、年龄、组织学分化程度、FIGO分期、深肌层浸润、宫旁浸润、淋巴结转移与患者生存率相关。采用Kaplan-Meier法进行生存分析,病毒低载量组患者4年总生存率为74.5%,高载量组4年总生存率为54.1%,差异有统计学意义(P<0.05)。Cox分析表明HPV16-E6-DNA病毒载量、淋巴结转移是影响患者生存状况的独立因素。结论HPV16-E6-DNA病毒载量与宫颈癌患者远期预后明显相关,可从分子水平预测患者的预后。

Objective This article is aimed at detecting HPV16-E6-DNA virus load in cervical cancer tissue and studying the prognostic impact of E6 expression on cervical carcinoma patients. Methods 84 cervical carcinoma patients were enrolled under strict inclusion and exclusion criteria. Total DNA was extracted from pathological tissue and formed into HPV16-E6-DNA plasmid. Then E6 virus load was detected by q PCR. The relation between clinical pathological characteristics and E6 virus load was studied by Spearman analysis.4-year survival rate of patients was counted by Kaplan-Meier method. Cox analysis was used to analyze various factors that affect patient＇s prognosis.Results Cervical cancer patient＇s age（ P = 0. 020）,FIGO staging（ P = 0. 000）,parametrium infiltration（ P = 0.007）,lymph node metastasis（ P = 0.004） were related to HPV16-E6-DNA virus load. E6-DNA expression（ P = 0. 023）,patients age（ P = 0. 000）,pathological differentiation degree（ P =0.040）,FIGO staging（ P = 0.000）,deep muscle infiltration（ P = 0.011）,parametrium infiltration（ P = 0.004）,lymph node metastasis（ P = 0.000） affected survival rate of patients. 4-year overall survival rate of patients with low E6 virus load was 74.5%,while the rate of patients with high E6 virus load was 54.1%. HPV-E6-DNA virus load and lymph node metastasis were independent prognostic affecting factors.Conclusions Hpv16-E6-DNA is evidently connected with the survival of cervical carcinoma patients which can be used as a prognostic marker.