晚期宫颈癌和盆腔淋巴结中高危HPV状态的预后意义

查看全文 作　　者：Fü le T.;Csapó Z.;Má thé M.;I. [1]Kovalszky;李奎 机构地区：[1]1st Department of Pathology and Experimental Cancer Research, Semmelweis University,lloi ú t 26, H-1085 Budapest, Hungary 出　　处：《世界核心医学期刊文摘(妇产科学分册)》索引2006年第0卷第8期,共1页 摘　　要：Objective. In this study, we investigated the presence of high- risk (HR) HPV types most prevalent in the Hungarian population in surgically removed cervical cancers and pelvic lymph nodes. The aim of our work was to determine the prognostic significance of HPV status in the lymph nodes draining the tumor. Methods. Primary tumor specimens from 150 patients and 900 lymph node samples (six per case) were studied. Fifty- six/150 were early (FIGO IA- IB) stage, while 94/150 were advanced (FIGO IIA- IIIB) stage cancers. Beside histopathological evaluation, DNA extracted from the tissue samples was subjected to nested PCR to detect characteristic type-specific sequences of HPVs 16, 18 and 33. Moreover, clinicopathological data were collected for an average 48- month postoperative follow-up period for the purposes of statistical analysis. Results. The presence of HR- HPV types in the lymph nodes shows no correlation with disease- free survival, whereas the presence of lymph node metastases significantly decreases life expectancy (P = 0.002). Lymph nodes with metastases more frequently carry HR- HPV than nodes with no evidence of tumorous infiltration (65% versus 36% , P < 0.001); however, a high number of metastases surrounding HR- HPV-positive tumors were found negative for the viruses (42/120). Conclusions. HR- HPV status of pelvic lymph nodes draining cervical cancers has no noticeable influence on the life expectancy of the patients. HR- HPV- positive tumor cells do not necessarily have a selective advantage in forming metastases. Presumably, a number of alterations in cellular genes rather than the presence of papillomavirus DNA may have a decisive role in the progression of cervical cancers. 关 键 词：晚期宫颈癌 盆腔淋巴结 预后意义 乳头瘤病毒 病毒检测 组织病理学 生存时间 无瘤生存率 特异性序列