乳腺癌HPV感染的形态学定位研究

Morphological localization of HPV infection in breast cancer patients

目的分析乳腺癌患者HPV感染的形态学定位。方法选取医院2011年1月-2017年1月收治的92例乳腺癌患者标本作为乳腺癌组,14例乳腺良性病变患者标本作为良性病变组,以医院同期采集的经PCR法证实HPV16/18或HPV31/33阳性宫颈癌标本作为阳性对照,对两组患者标本的病理诊断结果、透射电镜观察结果、HPV DNA分子原位杂交结果进行分析。结果 92例乳腺癌患者标本中,病理诊断78例为浸润性导管癌占84.78%,14例良性病变患者以乳腺增生症为主;92例乳腺癌患者标本中有28例乳腺癌细胞核内有HPV样病毒颗粒,阳性率为30.43%,14例乳腺良性病变患者中,细胞核内均无HPV样病毒颗粒,乳腺癌组患者HPV样病毒颗粒阳性率高于良性病变组(P=0.020);92例乳腺癌患者标本中,42例患者癌细胞核内HPV31/33DNA阳性,阳性率为45.65%;14例乳腺良性病变患者标本中,2例细胞核内HPV31/33DNA阳性,阳性率为14.29%,乳腺癌组患者HPV DNA分子原位杂交阳性率高于良性病变组(P=0.023);检测存在HPV DNA的患者中电镜下显示有病毒样颗粒的患者占总数的57.14%(24/42),二者的检测结果符合率为76.09%(24+46)/92。结论乳腺癌HPV感染的形态学定位对研究临床乳腺癌的发病原因分析、预防及治疗工作提供有效依据,值得临床重视。

OBJECTIVE To investigate the morphological localization of HPV infection in patients with breast cancer.METHODS The specimens that were obtained from 92 breast cancer patients who were treated in the hospital from Jan 2011 to Jan 2017 were assigned as the breast cancer group,the specimens that were obtained from 14 patients with benign breast lesions were assigned as the benign lesion group,and the specimens that were collected from the patients with cervical cancer who were confirmed positive for HPV16/18 or HPV31/33 through PCR were set as positive controls.The results of pathological diagnosis,transmission electron microscopy and HBV DNA molecular in situ hybridization of the specimens were observed.RESULTS Of the 92 breast cancer patients,78 were pathologically diagnosed with invasive ductal carcinoma,accounting for 84.78%;the patients with cyclomastopathy were dominant among the 14 patients with benign breast lesions.Among the 92 patients with breast cancer,28 were tested with HPV-like virions in cell nucleus of breast carcinoma,with the positive rate 30.43%;no patient was tested with HPV-like virions in cell nucleus among the 14 patients with benign breast lesions,and the positive rate of HPV-like virions of the breast cancer group was significantly higher than that of the benign lesion group（P=0.020）.Among the 92 patients with breast cancer,42 were tested positive for HPV31/33 DNA in carcinoma cell nucleus,with the positive rate 45.65%;among the 14 patients with benign breast lesions,2 were tested positive for HPV31/33 DNA in cell nucleus,with the positive rate 14.29%;the positive rate of HPV DNA molecular in situ hybridization of the breast cancer group was significantly higher than that of the benign lesion group（P=0.023）.The result of transmission electron microscopy showed that the patients who had the HPV-like virions accounted for 57.14% among the patients with positive HPV DNA,and the coincidence rate of the test results was 76.09%.CONCLUSION The morphological localization of HPV infection may provide effective evidence for clinical research,prevention and treatment of breast cancer,to which the hospital should attach great importance.