早期宫颈癌前哨淋巴结中高危型HPV16/18 DNA表达的检测及临床意义

目的：探讨早期宫颈癌患者前哨淋巴结（SLN）中人乳头状瘤病毒（HPV）16/18 DNA表达检测对于微转移的临床意义。方法选取72例早期宫颈癌患者，予患者均行广泛性子宫切除加双侧盆腔淋巴结清扫术，术中采用染料法识别SLN的宫颈癌患者有46例，应用基因检测法（FQ-PCR）检测SLN中HPV16/18 DNA阳性表达情况，并分析其与各种临床病理因素的关系；对SLN病理阴性的33例患者进行长期随访，分析SLN中HPV16/18 DNA阳性与淋巴结转移的关系。结果46例宫颈癌患者SLN中HPV16/18 DNA阳性表达者共22例，其中13例淋巴结病理阳性患者中有10例阳性，而33例淋巴结病理阴性患者中仅12例阳性（P=0.013）；46例患者共检出前哨淋巴结102枚，均用FQ-PCR法检测HPV16/18 DNA，结果13例淋巴结病理阳性患者检出的37枚SLN中有29枚HPV16/18 DNA阳性，而33例淋巴结病理阴性患者检出的65枚SLN中仅有36枚阳性（P=0.033）；分析46例成功检出SLN的早期宫颈癌患者的临床资料，发现SLN中HPV16/18 DNA阳性表达仅与临床分期有关，具有统计学意义（P=0.034）；长期随访33例SLN病理阴性的患者，发现HPV16/18 DNA阳性的患者复发率高于HPV16/18 DNA阴性的患者，具有统计学意义（P=0.02）。结论检测宫颈癌SLN组织中HPV16/18 DNA表达可能是预测早期宫颈癌淋巴结微转移的可行方法。

Detection of HPV16/18 DNA expression in sentinel lymph nodes in early stages cervical cancer

Objective To investigate the expression and significance of human papillomavirus (HPV) 16/18 DNA in pelvic sentinel lymph nodes (SLN) in early stage cervical carcinoma. Method 72 patients with early stages cervical can-cer were enrolled in the study, and were administered with radical hysterectomy and pelvic lymphadenectomy, 46 cases had SLN biopsies with staining, whose HPV16/18 DNA expression were examined by FQ-PCR, besides, the correlation with the clinical pathological factors were also investigated;long-term follow-up was conducted in 33 patients with patho-logically negative SLN, and the association between lymph node micrometastasis and HPV16/18 DNA was analyzed. Re-sult Of the 46 patients, 22 patients had positive expression of HPV16/18 DNA in SLN, in which there were 10 patients with positive DNA expression among 13 cases with lymph node metastasis, while in 33 patients with negative lymph node involvement, only 12 had positive expression (P=0.013);HPV16/18 DNA was detected using FQ-PCR, and a total of 102 SLNs were identified from the 46 patients, in the 37 SLNs of 13 cases with lymph node metastasis, there were 29 SLNs with positive HPV16/18, while in the 65 SLNs found in 33 cases of negative lymph involvement, only 36 SLNs were identified as positive (P=0.033);after reviewing the clinical profile of 46 cases with identified SLN, it was found that, the HPV16/18 DNA positive expression was associated with the clinical stage only, which was of statistical signifi-cance (P=0.034);in the long-term follow-up for 33 cases of negative SLN, a higher recurrence rate was observed in pa-tients with positive HPV16/18 DNA than that in those with negative HPV16/18 DNA, which was of statistical signifi-cance (P=0.02). Conclusion Detecting the expression of HPV16/18 DNA of SLN tissues maybe an available option for identifying SLN micrometastasis examination in early stages cervical carcinoma.