宫颈癌患者盆腔淋巴结HPV-DNA检测的临床意义

目的探讨宫颈癌患者盆腔淋巴结人类乳头瘤病毒（HPV）-DNA检测的临床意义.方法采用GP-PCR方法扩增宫颈癌患者盆腔淋巴结组织HPV-DNAL1区基因序列,通过序列分析对HPV进行型别鉴定,分析淋巴结HPV阳性率与淋巴转移组织病理学结果之间的关系.结果40例宫颈癌患者盆腔淋巴结HPV-DNA的检出率为40%;组织病理学发现淋巴转移的10例患者淋巴结HPV-DNA检测均为阳性;宫颈癌病灶中检测到HPV18型的患者盆腔淋巴结也都可检测到HPV18型.结论盆腔淋巴结中检出HPV-DNA阳性早于组织病理学出现转移,因此检测盆腔淋巴结中HPV-DNA对早期的淋巴结转移具有提示作用,有助于发现组织病理学不易发现的淋巴结隐匿性转移,提示预后不良.宫颈检测到HPV18型的患者更易发生淋巴转移,是预后不良的一种高危类型.

Significance of pelvic lymph node human papillomavirus DNA detection in cervical cancer

OBJECTIVE: To assess the significance of human papillomavirus (HPV) DNA detection in the pelvic lymph nodes in cervical cancer. METHODS: HPV L1 gene fragment was amplified by HPV-specific PCR with general consensus primers from cervical cancer tissues. The types of HPV were identified by sequencing of the PCR product. The relationship between HPV positivity and pathological findings in metastatic pelvic lymph nodes of cervical cancer was analyzed. RESULTS: The positivity rate of HPV DNA was 40% in the pelvic lymph nodes in 40 cases of cervical cancer. HPV DNA was detected in the pelvic lymphatic nodes of all the 10 cases with pathologically confirmed lymph node metastasis of cervical cancer. HPV18 was detected in both of cervical and pelvic lymph nodes in some cases. CONCLUSIONS: HPV DNA can be detected in the pelvic lymph nodes before pathological identification of lymph node metastasis and indicates early pelvic lymph node metastasis of cervical cancer. The presence of HPV18 often indicates high likeliness of lymph node metastasis and suggests poor prognosis of the patients.