2016 年第 6 期 第 14 卷

早期宫颈癌前哨淋巴结高危型HPV的检测及临床意义

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关键词：宫颈癌前哨淋巴结人乳头瘤病毒微转移

• 摘要：
• 【摘要】[摘要] 目的:探讨早期宫颈癌患者前哨淋巴结中HPV16/18的检测在早期宫颈癌中微转移的临床意义。方法:随机选择72例早期宫颈癌患者均行广泛性子宫切除加双侧盆腔淋巴结清扫术，采用染料法识别前哨淋巴结的宫颈癌患者46例，应用FQ-PCR方法检测46例早期宫颈癌前哨淋巴结HPV16/18的阳性率，分析前哨淋巴结组织HPV16/18阳性率与各种临床病理因素的关系，将前哨淋巴结病理提示无转移的33例患者进行长期随访，分析前哨淋巴结HPV16/18的存在与淋巴结转移的关系。结果：46例宫颈癌患者中前哨淋巴结HPV16/18阳性共22例，其中13例淋巴结病理阳性患者有10例HPV阳性，而33例淋巴结病理阴性患者仅12例HPV阳性，两种方法差异有统计学意义(P=0.013)。分析46例成功检出前哨淋巴结的早期宫颈癌患者的临床资料，发现前哨淋巴结HPV16/18阳性率与年龄、组织类型和肿瘤直径无关，但与临床分期有关(P =0.034 )，提示宫颈癌转移前哨淋巴结组织中HPV16/18型阳性率明显增高。长期随访33例前哨淋巴结病理提示无转移的患者，发现前哨淋巴结HPV16/18阳性的患者复发高于HPV16/18阴性的患者（P=0.02）。结论：检测前哨淋巴结HPV16/18 DNA可能是一个预测早期宫颈癌淋巴结微转移的可行方法。
• [Abstract] Objective: To investigate expression and significance of high risk human papilomavirus(HPV) in pelvic sentinel lymph nodes in early stages cervical carcinoma.Methods: Seventy-two patients affected by early stages cervical cancer had sentinel lymph node biopsies by performed during radical hysterectomy and pelvic lymphadenectomy. HPV 16/18 in46 patients identified with sentinel lymph nodes were examined by FQ-PCR. The relationship between the clinical pathological factors with HPV 16/18positive ratewas analyzed. Long-term follow-up was conducted with the 33 patients whose sentinel lymph nodes were pathological negative.Relationship of lymph node micrometastasiswithHPV 16/18was analyzed by statistical method. Results: Twenty-two patients with sentinel lymph nodes detected for HPV16/18 DNA positiveamong the 46 patients，in which 10 in 13 lymphatic pathologic positive patients were found HPV 16/18DNA positive，while only 12 were found positive in 33 lymphatic pathologic negative patients. And the HPV 16/18 positiverate was associated with the clinical stage.Long-term follow-up showed that therecurrence with HPV16/18 positive of sentinel lymph node was higher than that of HPV16/18negative.Conclusion:Detection of HPV 16/18 of sentinel lymph nodemay be an available method for sentinel lymph node micrometastasis examination in early stages cervical carcinoma.