宫颈腺癌患者人乳头状瘤病毒感染的基因分型研究

Genotypes of human papilloma virus causing infections in patients with cervical adenocarcinoma

目的研究分析宫颈腺癌患者感染人乳头状瘤病毒的基因分型,并探讨其临床意义。方法选取2010年1月-2015年1月医院收治的宫颈腺癌患者223例,设为A组,另选取同期健康体检女性223例设为B组。对所有患者进行标本活检采集,A组患者如果行手术治疗,则可取所切除的包块或赘生物作为标本;对宫颈腺癌患者的人乳头瘤病毒(HPV)基因型进行研究分析,方法采用DNA提取、巢式PCR技术;通过检测所得结果进行分析,观察宫颈腺癌患者HPV感染的病理特点和基因分型;记录随访过程中宫颈腺癌患者的无瘤生存时间和总生存时间。结果 A组患者中宫颈管内腺癌共115例,占51.57%,为宫颈腺癌最为常见的类型,其次为内膜样腺癌、透明细胞腺癌及腺样囊腺癌;A组患者中共有29例为交界模糊,占13.0%。本研究对两组中37例患者行免疫组化检查,结果显示,B组8例患者均为阴性反应,A组29例患者均为阳性反应,阳性率为100.0%;宫颈腺癌HPV基因型分布情况,223例患者中,单一型感染58例,感染率为26.01%,双重型感染75例,感染率为33.63%,多重感染90例,感染率为40.36%;其中HPV-16型感染106例,感染率为47.53%,HPV-18型感染123例,感染率为55.16%,HPV-16、HPV-18混合感染87例,感染率为39.01%。结论宫颈腺癌患者中HPV-16、HPV-18基因型感染最为常见,HPV18感染与早期宫颈腺癌的淋巴转移、侵犯脉管有关,HPV18感染、淋巴转移、侵犯脉管是无瘤生存时间和总生存时间的独立影响因素。

OBJECTIVE To explore the genotypes of human papilloma virus（HPV）causing infections in patients with cervical adenocarcinoma.METHODS Totally 223 patients with cervical adenocarcinoma who were treated in hospital from Jan 2010 to Jan 2015 were assigned as the group A,meanwhile,223 women who received physical examination were set as the group B.The specimens were obtained from all the patients through biopsy,the resected masses or neoplasms of the patients who received surgical procedures were taken as samples,the genotypes of HPV in the patients with cervical adenocarcinoma were observed by using DNA extraction and nested PCR technique.The results of the detection were analyzed,the pathological characteristics and genotypes were observed.The tumor-free survival time and total survival time of the cervical adenocarcinoma patients were recorded during the follow-up.RESULTS There were 115（51.57%）patients with intracervical adenocarcinoma in the group A,the intracervical adenocarcinoma was the most common cervical adenocarcinoma,followed by endometrioid adenocarcinoma,clear cell adenocarcinoma and adenoid cystic carcinoma.Totally 29 patients had blurred boundary in the group A,accounting for 13.0%.A total of 37 patients in the two group received immunohistochemical examination,and the result indicated that 8 patients showed negative reaction in the group B,29 patients in the group A,and the positive rate was 100%.Among 223 cervical adenocarcinoma patients with various HPV genotypes,58（26.01%）had single infection,75（33.63%）had duplex types of infection,and 90（40.36%）had multiple types of infection;106（47.53%）had HPV-16 infection,123（55.16%）had HPV-18 infection,and 87（39.01%）had mixed infection of HPV-16 and HPV-18.CONCLUSIONThe HPV16 and HPV18 are the most common genotypes in the cervical adenocarcinoma patients with HPV infection.The HPV18 infection is associated with lymphatic metastasis and vascular invasion.The HPV18 infection,lymphatic metastasis and vascular invasion are the independent influencing factors for tumor-free survival time and total survival time.