基因芯片检测宫颈癌石蜡标本HPV感染的临床意义

目的探讨用基因芯片检测宫颈癌石蜡标本中人乳头瘤病毒(HPV)感染的可行性和临床意义。方法收集2005年5月-2007年2月在解放军总医院住院的宫颈癌患者的石蜡组织标本48例,其中鳞癌37例,腺癌11例。从组织中提取DNA后,应用基因芯片检测23种HPV亚型,即PCR扩增后产物在基因芯片上进行杂交。结果基因芯片检测出44例宫颈癌有高危型HPV感染,感染率为91.7%(44/48),其中宫颈鳞癌的感染率为94.6%(35/37),宫颈腺癌的感染率为81.8%(9/11)。单一感染33例,占75.0%(33/44);混合感染11例,其中双重感染9例,多重感染2例,分别占20.5%(9/44)和4.6%(2/44)。基因芯片检测出的主要致病亚型为HPV16,占90.9%(40/44);HPV18为第二致病亚型,占27.3%(12/44);HPV52、33、59、68等致病亚型较少见。35例宫颈鳞癌HPV感染患者中,HPV16亚型感染率为91.4%(32/35),HPV18亚型感染率为22.9%(8/35);9例宫颈腺癌中,HPV16亚型感染率为88.9%(8/9),HPV18亚型占44.4%(4/9)。结论基因芯片可检测出多种HPV亚型,特异性强,敏感性高,对宫颈癌致病机制的研究及其预防具有重要意义。

Clinical significance of detection of human papilloma virus (HPV) infection with microarray from paraffin-embedded specimens of cervical cancer

Objective To discuss the clinical significance of human papilloma virus (HPV) infection in cervical cancer and to explore the feasibility of detecting the infection with microarray from paraffin-embedded specimens of cervical cancer. Methods From May 2005 to February 2007, 48 patients with cervical carcinoma, including 37 cases with cervical squamous cell carcinoma and 11 cases with cervical adenocarcinoma, were analyzed retrospectively. After DNA extraction from the paraffin-embedded tissues, 23 HPV subtypes were detected by the use of microarray after amplification by polymerase chain reaction (PCR) and hybridization. Results 44 cases of cervical cancer were found to be high-risk HPV positive genotypes. The HPV infection rate was 91.7%. The HPV infection rate in cervical squamous cell carcinoma was 94.6% (35/37), and in cervical adenocarcinoma was 81.8% (9/11). Among them, 33 cases were found to have single infection, accounting for 75.0% of the infection rate. There were 11 cases of mixed infection, among them 9 cases were found to have double infection and 2 cases with multiple infection, accounting for 20.5% and 4.6%, respectively, of the infection rate. The infection rate of HPV16, the main genotype, was 90.9% (40/44). The infection rate of HPV18, the second ranking subtype, was 27.3% (12/44). Infection with HPV52, 33, 59, and 68 genotypes was lower in incidence. Among 35 cases of cervical squamous cell carcinoma, the infection rates of HPV16 and HPV18 were 91.4% (32/35) and 22.9% (8/35), respectively. Among 9 cases of cervical adenocarcinoma, the infection rate of HPV16 and HPV18 were 88.9% (8/9) and 44.4% (4/9), respectively. Conclusion Multiple HPV genotypes can be detected from paraffin-embedded tissues with microarray technique in high sensitivity and specificity, and it is useful to study the pathogenesis and prevention of cervical cancer.