中晚期宫颈癌HPV感染阳性患者放疗随访期HPV及TCT变化及相关性研究

Change and correlation of HPV and TCT in follow-up monitoring of HPV-infected patients with interim and advanced cervical cancer after radiation therapy

目的探讨中晚期宫颈癌人乳头瘤病毒(HPV)感染阳性患者放疗随访期HPV及液基薄层细胞学检查(TCT)变化及相关性,为宫颈癌放疗的随访提供参考。方法随机收集2014年1月-2015年12月于医院诊断为中晚期宫颈癌HPV感染阳性行放疗治疗的100例患者临床资料进行回顾性分析,患者放疗前后随访期间均采用聚合酶链反应加膜杂交法检测HPV感染状况,同时行TCT检测。结果患者放疗前HPV阳性率为100.00%,放疗后随访3、6、9、12个月时HPV阳性率分别为52.00%、32.00%、24.00%、15.00%,放疗前后不同时点HPV阳性率比较差异有统计学意义(P<0.05);患者放疗前TCT阳性率为100.00%,放疗后随访3、6、9、12个月时TCT阳性率分别为79.00%、58.00%、46.00%、32.00%,放疗前后不同时点TCT阳性率比较差异有统计学意义(P<0.05);随访12个月时病情控制患者HPV阳性率为8.79%、TCT阳性率为25.27%,病情进展患者HPV阳性率为77.78%、TCT阳性率为100.00%,病情控制与进展患者HPV及TCT阳性率比较差异有统计学意义(P<0.05);患者放疗后随访3、6、9、12个月时HPV与TCT阳性率之间有正相关性(P<0.05)。结论中晚期宫颈癌HPV感染阳性患者放疗随访期HPV及TCT阳性率表现为下降趋势,两者关系密切,在放疗随访期密切监测两者指标的变化,有助于观察患者病情的发展方向。

OBJECTIVE To study change and correlation of human papillom avirus（HPV）and thin-prep cytology test（TCT）in follow-up monitoring of HPV infected patients with interim and advanced cervical cancer after radiation therapy,so as to provide references for follow-up monitoring of cervical cancer patients.METHODS The clinical data of 100 cases of HPV-infected patients diagnosed with interim and advanced cervical cancer and underwent radiation therapy from Jan.2014 to Dec.2015 were randomly collected and retrospectively analyzed.Polymerase chain reaction and membrane hybridization were used to detect HPV infection,and TCT was performed simultaneously before radiotherapy and during follow-up after radiotherapy.RESULTS The positive rate of HPV was100.00% before radiotherapy,and the positive rates in 3,6,9 and 12 months after radiation therapy were52.00%,32.00%,24.00% and 15.00%.There were significant differences in HPV positive rates at different time points before and after radiotherapy（P〈0.05）.The positive rate of TCT was 100.00% before radiotherapy,and the positive rates in 3,6,9 and 12 months after radiation therapy were 79.00%,58.00%,46.00% and 32.00%.There were significant differences in TCT positive rates at different time points before and after radiotherapy（P〈0.05）.The positive rates of HPV and TCT were 8.79%and 25.27%respectively in 12 months after radiotherapy in the patients with disease control.The positive rates of HPV and TCT were 77.78% and 100.00% respectively in12 months after radiotherapy in patients with disease progression.There were significant differences in HPV and TCT positive rates between patients with disease control and disease progression（P〈0.05）.There was positive correlation between HPV and TCT positive rates in 3,6,9 and 12 months after radiotherapy（P〈0.05）.CONCLUSION HPV and TCT positive rates in follow-up monitoring of HPVinfected patients with interim and advanced cervical cancer after radiotherapy shows a descending trend,and these two values were closely related with each other.The changes of these two indicators should be intensively monitored during the follow-up monitoring of radiotherapy,which would help to observe the development direction of the patient＇s condition.