子宫颈腺癌石蜡包埋组织中人类乳头状瘤病毒型别分布及其与患者年龄的关系

 【摘要】　目的　探讨子宫颈腺癌中人类乳头状瘤病毒（HPV）的分布情况及HPV感染与患者年龄的关系。方法　采用描述流行病学研究设计，纳入32例来自一项多中心临床研究的经病理确诊的子宫颈腺癌患者的标本。采用三明治技术进行石蜡包埋组织的切片，SPF10-PCR技术进行DNA扩增，使用反向杂交线型探针检测技术（LiPA）进行HPV分型；对所有切片进行病理阅片和诊断，分析确诊为子宫颈腺癌标本的HPV分布情况，并行统计学分析。结果　32例腺癌患者中，HPV阳性率为53.1 %（17／32）。HPV-18为最主要HPV型别，占HPV阳性患者的47.4 %（8／17），其次为HPV-16，占HPV阳性患者的26.3 %（5／17）。检测到的其他型别为HPV-39、HPV-45和HPV-66；多重感染者1例（HPV-18和HPV-66）。HPV-16与HPV-18相比，其阳性的腺癌患者平均年龄分别为48.6和40.6岁，差异有统计学意义（P＝0.048）。采用<50岁以及≥50岁作为年龄分组，HPV任意型别阳性率在两个年龄组中的差异无统计学意义（P＝0.074）。HPV-18在两个年龄组的腺癌患者和HPV阳性腺癌患者中的分布均差异有统计学意义（P＝0.003、P＝0.029）。HPV-16在两个年龄组腺癌患者中和在HPV阳性的腺癌患者中的分布差异无统计学意义（P＝1、P＝0.6）。HPV-16和（或）HPV-18感染在两个年龄组HPV阳性腺癌患者中的阳性率差异无统计学意义（P＝0.052），但在全部腺癌患者两个年龄组中阳性率差异有统计学意义（P＝0.005）。结论　HPV-18和HPV-16是子宫颈腺癌中最主要分布的两种HPV型别。HPV阳性尤其HPV-18阳性在年轻的腺癌患者中更为常见。HPV-16阳性较HPV-18阳性在年龄较大的妇女中更为常见。

Distribution of type-specific human papillomavirus and its characters on age in paraffin-embedded adenocarcinoma specimens

Objective Human Papillomavirus (HPV) is necessary to the development of cervical cancer.Until now,the distribution of specific HPV type has not been identified clearly yet.Besides,the relationship between age and the HPV type-specific distribution in cervical adenocarcinoma needs to be further investigated.Methods This study included 32 specimens of cervical adenocarcinoma out of a multicenter clinical study in China.The specimen blocks were sliced by sandwich method.DNA was amplified by SPF10-PCR method.DNA genotyping used LiPA method.All biopsy specimens had pathologic diagnosis.The prevalence of HPV type-specific distribution was described and the differences were analyzed statistically.Results 32 adenocarcinoma cases were included in this sttudy.HPV positive rate was 53.1％ (17/32).HPV-18 was the most prevalent type,which took up 47.4 ％ (8/17) of the total HPV positive cases,followed by HPV-16,which took up 26.3 ％ (5/17) of the total HPV positive cases.Other HPV types detected were HPV-39,HPV-45 and HPV-66.One multi-infection case was found (HPV-18 and HPV-66 co-infection).The average ages of HPV-16 and HPV-18 were 48.6 and 40.6 years old respectively,which showed statistically difference (P =0.049).When the patients younger than 50 years old were compared with the patients equal or older than 50 years old as two age groups,HPV positive rate did not show significantly statistical difference (P =0.074) between the two age groups.The prevalence of HPV-18 manifested significant differences between the two age groups in both HPV positive adenocarcinoma cases and overall adenocarcinoma cases (P =0.029and P =0.003 respectively).The prevalence of HPV-16 did not show any significant statistical difference between the two age groups in either HPV positive adenocarcinoma cases or overall adenocarcinoma cases (P =0.6 and P =1 respectively).HPV-16 and/or HPV-18 infection (at least one positive) in HPV positive adenocarcinoma cases did not have statistical significance (P =0.052),while in overall adenocarcinoma cases,HPV-16 and/or HPV-18 infection presented significant statistical difference (P =0.005).Conclusion HPV-18 and HPV-16 were two most prevalent HPV types in cervical adenocarcinoma.HPV infection and HPV-18infection were more common in young women.The prevalence of HPV-16 was more common in older adenocarcinoma cases compared with HPV-18.Those findings will provide evidence for the evaluation of HPV vaccine in preventing cervix related diseases.