HPV不同亚型感染状况及基因分型与胃癌病变、预后的相关性研究

A study on the infection status and genotyping of different HPV subtypes and the correlation with gastric cancer lesions and prognosis

目的探讨胃癌组织中人乳头瘤病毒(HPV)不同亚型感染状况及各基因分型与胃癌患者预后的关系。方法收集2015年2月—2017年10月于本院进行手术切除的246例胃癌患者的组织及临床资料,采用HPV基因分型PCR检测试剂盒进行定性检测;采用Kaplan-Meier法分析胃癌患者预后与HPV18、HPV16阳性的关系,并绘制生存曲线;采用多因素Cox回归分析胃癌患者预后的影响因素。结果246例胃癌患者中,HPV感染阳性率为73.98%,共检测到8种高危型(HR)-HPV基因亚型和5种低危型(LR)-HPV基因亚型。HR-HPV基因亚型中HPV18(39.84%)和HPV16(19.51%)的阳性率最高,LR-HPV基因亚型中HPV42(3.25%)的阳性率最高。不同年龄、性别、Lauren分型、肿瘤直径、分化程度胃癌患者胃癌组织中HPV18及HPV16阳性率比较,差异无统计学意义(P>0.05);TNM分期为Ⅲ+Ⅳ期、有淋巴结转移的胃癌患者胃癌组织中HPV18及HPV16阳性率高于TNM分期为Ⅰ+Ⅱ期、无淋巴结转移的胃癌患者(P<0.05)。HPV18阴性组5年内生存率高于HPV18阳性组(χ^(2)=20.361,P<0.05),HPV16阴性组5年内生存率高于HPV16阳性组(χ^(2)=11.648,P<0.05)。TNM分期、HPV18阳性是胃癌患者死亡的独立危险因素(P<0.05)。结论HPV18是胃癌患者中最常见的HPV基因亚型,且是影响胃癌患者预后的重要因素。

Objective This paper aims to investigate the infection status and genotyping of different subtypes of human papillo⁃mavirus(HPV)in gastric cancer tissue and their relationship with the prognosis of gastric cancer.Methods The tissue and clinical data were collected from 246 patients with gastric cancer who underwent surgical resection in our hospital from February 2015 to October 2017.HPV genotyping PCR detection kit was used for qualitative detection;Kaplan-Meier method was per⁃formed to analyze the relationship between the prognosis of gastric cancer patients and the positiveness of HPV18 and HPV16 and draw a survival curve;Multivariate Cox regression was performed to analyze the factors affecting the prognosis of gastric cancer patients.Results Among 246 patients with gastric cancer,the positive rate of HPV infection was 73.98%.A total of 8 high-risk(HR)-HPV genotypes and 5 low-risk(LR)-HPV genotypes were detected.HPV18(39.84%)and HPV16(19.51%)had the highest positive rates among HR-HPV genotypes,and HPV42(3.25%)had the highest positive rate among LR-HPV genotypes.There was no statistical significance on the difference in the positive rates of HPV18 and HPV16 in gastric cancer tissues of gastric cancer patients with different age,gender,Lauren classification,tumor diameter,and degree of differentiation(P>0.05).The positive rates of HPV18 and HPV16 in gastric cancer tissues of gastric cancer patients with TNM stageⅢ+Ⅳand lymph node metastasis were higher than those of gastric cancer patients with TNM stageⅠ+Ⅱand non-lymph node metastasis(P<0.05).The 5-year survival rate of the HPV18-negative group was higher than that of the HPV18-positive group(χ^(2)=20.361,P<0.05),and the 5-year survival rate of the HPV16-negative group was higher than that of the HPV16-positive group(χ^(2)=11.648,P<0.05).TNM staging and HPV18 positive were independent risk factors for the death of patients with gastric cancer(P<0.05).Conclusion HPV18 is the most common HPV genotype among gastric cancer patients,and it is an important factor affecting the prognosis of gastric cancer patients.