安徽地区宫颈癌患者HPV感染状况及其在放疗疗效监测中的应用

doi:10.3969/j.issn.1673-8640.2019.10.007

摘要/Abstract

摘要： 目的分析安徽地区宫颈癌患者HPV感染情况及其亚型分布,探讨宫颈癌患者HPV感染与临床病理特征的相关性及放疗前后HPV DNA拷贝数的变化与放疗疗效的关系。方法选取宫颈癌患者230例,采用实时荧光定量聚合酶链反应（PCR）检测15种常见高危型HPV DNA,分析宫颈癌患者HPV感染的阳性率、亚型分布特征及其与患者年龄、临床分期之间的关系,以及放疗前后HPV DNA拷贝数的变化与放疗疗效的关系。结果 230例宫颈癌患者HPV感染阳性率为83.0%, 单一亚型感染阳性率为73.2%,多重亚型感染阳性率为26.8%。宫颈癌患者HPV感染的亚型以16、18和58型为主;HPV感染与患者年龄无关,与患者临床分期有关（P<0.05）,分期越晚感染率越低。放疗对单一亚型感染的有效率高于多重亚型感染,且放疗有效的患者HPV DNA拷贝数较放疗前减少,放疗无效患者HPV DNA拷贝数有增多趋势。结论安徽地区宫颈癌患者HPV感染以16、18和58型为主,HPV感染的亚型和DNA拷贝数的变化可以作为放疗疗效监测的指标。

关键词: 人乳头瘤病毒, 宫颈癌, 基因型, 放疗

Abstract: Objective To analyze the human papillomavirus（HPV） infection status and the subtype distribution of cervical cancer patients in Anhui,and to investigate the correlation between HPV infection and clinical pathological characteristics of cervical cancer patients and the relationship between HPV DNA copy number changes and the efficiency of radiotherapy. Methods A total of 230 patients with cervical cancer were enrolled. Real-time fluorescence quantitative polymerase chain reaction（PCR） was used to determine 15 common high-risk HPV DNA subtypes,and the positive rate and subtype distribution characteristics of HPV infection in patients with cervical cancer were analyzed. The relationship between positive rate and subtype distribution in ages and clinical stages and the relationship between the copy number changes of HPV DNA and the efficiency of radiotherapy in patients with cervical cancer were evaluated. Results The positive rate of HPV infection in 230 patients with cervical cancer was 83.0%,the single subtype positive rate was 73.2%,and the multiple subtype positive rate was 26.8%. The subtypes of HPV infection in cervical cancer patients were mainly HPV 16,18 and 58. HPV infection was not correlated with ages,but it was related to clinical stages（P<0.05）. The later clinical stages made lower infection rates. The single subtype infection rate after radiotherapy was higher than that before radiotherapy,the radiotherapy efficiency of single subtype infection was higher than that of multiple subtype infection,and the copy number in invalid group would increase. Conclusions HPV infection in patients with cervical cancer in Anhui is dominated by HPV 16,18 and 58. HPV subtype and copy number of HPV infection could be used as the indicators for evaluating the efficiency of radiotherapy.

Key words: Human papillomavirus, Cervical cancer, Genotype, Radiotherapy

中图分类号:

R446.1

孙永梅, 陈兆武, 张扬, 万玲玲, 李明, 邓芳. 安徽地区宫颈癌患者HPV感染状况及其在放疗疗效监测中的应用[J]. 检验医学, 2019, 34(10): 897-900.

SUN Yongmei, CHEN Zhaowu, ZHANG Yang, WAN Lingling, LI Ming, DENG Fang. HPV infection status of cervical cancer patients in Anhui and role of HPV determination in monitoring the curative effect of radiotherapy[J]. Laboratory Medicine, 2019, 34(10): 897-900.

图/表 5

参考文献 14

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HPV亚型	HPV阳性（例）	百分比（%）
16型	76	29.9
58型	33	13.0
18型	26	10.2
52型	23	9.1
51型	17	6.7
56型	15	5.9
39型	13	5.1
59型	12	4.7
66型	10	3.9
33型	8	3.1
68型	7	2.8
35型	4	1.6
31型	4	1.6
45型	3	1.2
82型	3	1.2

HPV亚型	HPV阳性（例）	百分比（%）
16型	76	29.9
58型	33	13.0
18型	26	10.2
52型	23	9.1
51型	17	6.7
56型	15	5.9
39型	13	5.1
59型	12	4.7
66型	10	3.9
33型	8	3.1
68型	7	2.8
35型	4	1.6
31型	4	1.6
45型	3	1.2
82型	3	1.2

项目	例数	HPV阳性	HPV阴性
年龄（岁）
≤49	109	89（81.7）	20（18.3）
>49	121	101（83.5）	20（16.5）
临床分期
Ⅰ~Ⅱ期	198	168（84.8）^*	30（15.2）
Ⅲ~Ⅳ期	32	22（68.7）	10（31.3）

项目	例数	HPV阳性	HPV阴性
年龄（岁）
≤49	109	89（81.7）	20（18.3）
>49	121	101（83.5）	20（16.5）
临床分期
Ⅰ~Ⅱ期	198	168（84.8）^*	30（15.2）
Ⅲ~Ⅳ期	32	22（68.7）	10（31.3）

项目	例数	单一亚型	多重亚型
年龄（岁）
≤49	89	66（74.2）	23（25.8）
>49	101	73（72.3）	28（27.7）
临床分期
Ⅰ~Ⅱ期	168	126（75.0）	42（25.0）
Ⅲ~Ⅳ期	22	13（59.0）	9（41.0）