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目的研究宫颈癌患者人乳头瘤病毒(HPV)感染负荷量及宫颈癌组织HPV-E6蛋白表达与新辅助化疗效果的相关性,探讨其预测宫颈癌化疗效果的可能性。方法收集云南省肿瘤医院2010年6月~2011年12月收治的40例宫颈癌患者,对其进行新辅助化疗1~3个疗程,化疗结束后4周评价治疗效果;化疗前采用二代杂交捕获技术(hc2HPV DNA)检测HPV负荷量,免疫组化MaxVision法检测宫颈癌组织HPV-E6蛋白表达,研究化疗效果与化疗前HPV负荷量、HPV-E6蛋白表达的关系。结果新辅助化疗临床有效率为85%。宫颈鳞癌患者HPV感染负荷量为466.78±695.48,显著高于腺癌患者的277.78±167.72(P<0.05)。化疗有效组HPV感染负荷量为472.40±726.62,显著低于化疗无效组的1 969.68±32.19,宫颈癌患者HPV感染负荷量与新辅助化疗效果呈负相关(P<0.05)。宫颈癌组织HPV-E6蛋白表达与宫颈癌病理类型、分期、HPV负荷量及新辅助化疗疗效均无相关性(P>0.05)。结论 HPV感染负荷量与宫颈癌新辅助化疗效果有关,其负荷量越大化疗效果越差,通过宫颈癌患者HPV负荷量可有效预测宫颈癌新辅助化疗效果。
Objective To study the relationship between HPV infection load and HPV-E6 expression in patients with cervical cancer and the effect of neoadjuvant chemotherapy, and to explore the possibility of predicting the effect of chemotherapy for cervical cancer. Methods Forty patients with cervical cancer who were treated in Yunnan Tumor Hospital from June 2010 to December 2011 were enrolled in this study. The patients were treated with neoadjuvant chemotherapy for 1 to 3 courses and the therapeutic effect was evaluated 4 weeks after the end of chemotherapy. The hC2HPV DNA was used to detect the HPV load. The MaxVision method was used to detect the expression of HPV-E6 in cervical cancer. The relationship between the chemotherapy effect and HPV load and HPV-E6 protein expression before chemotherapy was studied. Results The neoadjuvant chemotherapy clinical effective rate was 85%. The HPV infection load of cervical squamous cell carcinoma patients was 466.78 ± 695.48, which was significantly higher than that of adenocarcinoma patients (277.78 ± 167.72, P <0.05). The effective rate of HPV infection was 472.40 ± 726.62 in chemotherapy-effective group, which was significantly lower than that of chemotherapy-ineffective group (9659.68 ± 32.19). HPV infection load in cervical cancer patients was negatively correlated with neoadjuvant chemotherapy (P <0.05). There was no correlation between HPV-E6 protein expression and pathological type, stage, HPV load and neoadjuvant chemotherapy in cervical cancer (P> 0.05). Conclusion The HPV infection load is related to the neoadjuvant chemotherapy effect of cervical cancer. The greater the load is, the worse the chemotherapy effect is. The HPV load of cervical cancer patients can effectively predict the effect of neoadjuvant chemotherapy for cervical cancer.