【摘要】 目的明确少见类型的宫颈癌患者HPV感染亚型种类,以期评估HPV疫苗对这组宫颈癌的预防效果。方法收集2014年9月~2017年9月就诊于四川大学华西二院的少见类型宫颈癌患者病例,HPV基因分型检测采用PCR和Luminex流式荧光技术进行,分析HPV感染情况及基因型分布,经计算特定HPV亚型的阳性比例来评价HPV亚型对宫颈癌的相对贡献。采用比例权重归因(PWA)方法将多重感染中亚型占比折算至相应的单型别感染。结果纳入病例143例,HPV阳性数为130例,阳性率90.91%,其中黏液腺癌60例(46.15%)、腺鳞癌46例(35.38%)、神经内分泌癌8例(6.15%)和混合类型16例(12.31%),其中单一感染109例(83.84%),多重感染为21例(16.15%),HPV16和18亚型为各组中占比最大的亚型,在黏液腺癌、腺鳞癌、神经内分泌癌和混合类型中分别是85.88%、93.39%、100.00%和83.32%。结论 HPV16/18亚型是这组少见类型宫颈癌患者感染的主要亚型,九价疫苗对于本组宫颈癌的预防效果有一定提高。更多还原

【Abstract】 Objective To provide more evidence for the estimation of potential impact of HPV vaccine, by analyzing the distribution of HPV genotypes in unusual types of cervical cancer. Methods From September 2014 to September 2017,in West China Second Hospital of Sichuan University, unusual types of cervical cancer were collected, HPV genotyping was done by use of PCR and Luminex fluorescence technique. Relative contribution of HPV types in ICCs was expressed as the percentages of type-specifc cases among HPV-positive cases. Multiple infections were incorporated into single infection using the method of proportional weighting attribution(PWA). Results In the study, 143 invasive cervical cancer cases were included, and 130(90.91%) cases were positive for HPV DNA, among them, 60(46.15%) cases were adenocarcinoma(ADC), 46(35.38%) cases were adenosquamous cell carcinoma(ADSCC), 8(6.15%) cases were neuroendocrine carcinoma(NECA) and 16(12.31%) cases were mixed type, 109(83.84%) cases were present as single infections and 21(16.15%) cases were present as multiple infections. HPV types 16 and 18 were the major types in each histological group. The PWA of HPV 16/18 to ADC, ADSCC, NECA and mixed type were 85.88%, 93.39%, 100.00%and 83.32%, respectively. Conclusion HPV 16 and 18 infections are predominant in these unusual types of cervical cancer. The 9-valent HPV vaccine has some improvement for prevention of these unusual types of cervical cancer.更多还原