宫颈癌患者淋巴结中HPV DNA检测的临床意义

目的通过分析宫颈癌患者术后切除淋巴结及癌灶中人乳头瘤病毒(HPV)DNA的检出情况,探讨淋巴结中HPVDNA的检测在判断淋巴微小转移中的临床意义。方法利用原位杂交技术(ISH)检测HPVDNA16/18在42例Ib～IIb期宫颈癌患者病灶中的表达,同时检测31例HPVDNA16/18表达阳性患者左右闭孔、左右髂内124个淋巴结中HPVDNA16/18的检出情况,分析淋巴结HPVDNA的存在与淋巴结转移的相关关系。结果73.8%(31/42)癌灶组织可以检测到HPVDNA16/18。病理学证实75%(12/16)的转移病例淋巴结中检测到HPVDNA16/18,33.3%(5/15)未转移病例的淋巴结中也可以检测到HPVDNA16/18。病理转移淋巴结中HPVDNA的表达率高于未转移淋巴结(P<0.05)。FIGO分期晚的宫颈癌患者,淋巴结HPVDNA的表达率高(P<0.05)。结论保存完好的淋巴结石蜡切片可以用ISH来检测HPVDNA。HPVDNA不仅与宫颈癌的发生有关,而且与肿瘤的转移有关。宫颈癌患者淋巴结的HPVDNA检查比病理学检查更安全。

Clinical Significance of Human Papillomavivus DNA Detection in Lymph Nodes of Patients with Cervical Carcinoma

Objective To detect human papillomavirus (HPV) DNA in dissected lymph nodes and its clinical significance in the pathological confirmation of metastasis. Methods 124 dissected lymph nodes(left and right external iliac lymph nodes,left and right obturator lymph nodes) were obtained from 31 patients with cervical carcinoma during surgical treatment. The presence of HPV DNA was detected in situ by hybridization(ISH). Results HPV DNA was found in 31 of the primary lesions(73.8%),in 75% lymph nodes with metastases confirmed histopathologically (12/16) and in 33.3% free lymph nodes without metastases. The expression of HPV DNA in the former was higher than that in the laster (P < 0.05). The expression of HPV DNA in the lymph nodes was correlated with the volume of the primary lesion. Conclusion Archival cytology slides can be used for HPV DNA detection with ISH. The expression of HPV DNA in metastases lymph nodes is higher than that in free lymph nodes. HPV DNA not only is involved in the genesis of cervical carcinoma but also plays an important role in the development of its metastasis.