学术论文

      高危型人乳头状瘤病毒病毒载量与宫颈癌临床病理因素关系的研究

      Relationship between high-risk human papillomavirus viral load and clinical pathological factors of cervical cancer

      摘要:
      目的 研究高危型人乳头状瘤病毒(HR-HPV)病毒载量与宫颈癌临床病理因素的关系.方法 选取初次治疗、经病理学检查诊断为宫颈癌患者97例,对HR-HPV病毒载量与宫颈癌临床病理因素的关系进行分析.结果 宫颈癌Ⅰ期患者(45例)HR-HPV病毒载量显著高于宫颈癌Ⅱ期(29例)、宫颈癌 ≥Ⅲ期(23例)患者[484.03(289.22,773.54)RLU/CO比88.24(53.15,133.30)和41.41(13.39,164.21)RLU/CO],差异有统计学意义(P<0.05);宫颈癌Ⅱ期患者与宫颈癌≥Ⅲ期患者比较差异无统计学意义(P>0.05).宫颈癌<ⅡB期(48例)患者HR-HPV病毒载量明显高于宫颈癌≥ⅡB期患者(49例)[464.23(235.66,742.89)RLU/CO比61.87(22.85,138.82)RLU/CO],差异有统计学意义(P<0.05).将患者按HR-HPV病毒载量分为>100 RLU/CO组(57例)和≤100 RLU/CO组(40例),≤100 RLU/CO组宫颈癌≥ⅡB期比率明显高于>100 RLU/CO组[75.0%(30/40)比33.3%(19/57)],差异有统计学意义(P<0.01).97例宫颈癌患者中,高分化9例、中分化58例、低分化19例、分化程度不清11例.去除分化程度不清患者,高中分化患者HR-HPV病毒载量明显高于低分化患者[173.56(62.76,523.92)RLU/CO比45.71(4.05,164.21)RLU/CO],差异有统计学意义(P<0.05).结论 HR-HPV病毒载量随宫颈癌临床分期及病理分级的进展而降低,提示其在宫颈癌进展中的作用可能不显著,低HR-HPV病毒载量在≥ⅡB期的宫颈癌中常见,可能提示低病毒载量是宫颈癌患者预后不良的指标之一.
      Abstract:
      Objective To study the relationship between high-risk human papillomavirus (HR- HPV) viral load and clinical pathological factors of cervical cancer. Methods Ninety- seven initial treatment patients with cervical cancer were selected, and they were diagnosed by pathological examination. The relationship was analyzed between HR-HPV viral load and clinical pathological factors of cervical cancer. Results The HR- HPV viral load in cervical cancer Ⅰ stage (45 cases) was significantly higher than that in cervical cancer Ⅱ stage (29 cases) and cervical cancer ≥Ⅲ stage (23 cases):484.03 (289.22, 773.54) RLU/CO vs. 88.24 (53.15, 133.30) and 41.41 (13.39, 164.21) RLU/CO, and there was statistical difference (P<0.05); but there was no statistical difference between cervical cancerⅡstage and cervical cancer≥Ⅲstage (P>0.05). The HR-HPV viral load in cervical cancer<ⅡB stage (48 cases) was significantly higher than that in cervical cancer ≥ⅡB stage (49 cases): 464.23 (235.66, 742.89) RLU/CO vs. 61.87 (22.85, 138.82) RLU/CO, and there was statistical difference (P<0.05). The patients were divided into >100 RLU/CO group (57 cases) and ≤100 RLU/CO group (40 cases) according to the HR- HPV viral load. The rate of cervical cancer ≥ⅡB stage in ≤100 RLU/CO group was significantly higher than that in>100 RLU/CO group:75.0%(30/40) vs. 33.3%(19/57), and there was statistical difference (P<0.01). Among 97 patients with cervical cancer, well-differentiated was in 9 cases, moderately differentiated in 58 cases, poorly differentiated in 19 cases, and the degree of differentiation was not clear in 11 cases. The HR- HPV viral load in well and moderately differentiated patients was significantly higher than that in poorly differentiated patients: 173.56 (62.76, 523.92) RLU/CO vs. 45.71 (4.05, 164.21) RLU/CO, and there was statistical difference (P<0.05). Conclusions The HR-HPV viral load is decreased with the progression of cervical cancer clinical staging and pathological grading. It shows that HR-HPV viral load in the progression of cervical cancer is not obvious. Lower HR-HPV viral load is common in cervical cancer≥ⅡB stage. It may indicate that low viral load is one of the indicators of poor prognosis in patients with cervical cancer.
      作者单位: 100006,首都医科大学附属北京妇产医院妇瘤科
      刊 名: 中国医师进修杂志 ISTIC
      年,卷(期): 2017, 40(3)
      在线出版日期: 2017年3月31日