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目的探讨宫颈人乳头瘤病毒(HPV)感染患者的病毒亚型,与上皮细胞黏附分子(EpCAM)表达水平的相关性。方法采用半定量聚合酶链式反应检测宫颈分泌物的HPV亚型,免疫组化检测宫颈组织EpCAM的表达,使用5-氨基酮戊酸光动力(ALA-PDT)治疗3次,每周一次,随访3个月。结果共调查患者45例。其中感染高危型HPV 18例,占比40.0%;混合感染(两种以上亚型)14例,占比31.1%。EpCAM免疫组化表达阳性6例。光动力治疗临床治愈38例,复发7例。HPV亚型(高危/低危)与EpCAM阳性表达呈正相关;HPV(混合/单一)感染与EpCAM阳性表达无关。不良反应:3例患者诉阴道分泌物增多,未行特殊处理,一周后自行缓解。结论光动力是宫颈HPV感染有效治疗方法之一,高危型病毒感染与EpCAM表达有关。
Objective To investigate the relationship between viral subtype and epithelial cell adhesion molecule (EpCAM) expression in patients with cervical papillomavirus (HPV) infection. Methods The HPV subtype of cervical secretions was detected by semi-quantitative polymerase chain reaction. The expression of EpCAM in cervical tissues was detected by immunohistochemistry. The cells were treated with 5-aminolevulinic acid (ALA-PDT) three times a week, Follow-up 3 months. Results A total of 45 patients were investigated. Among them, 18 cases were infected with high-risk HPV, accounting for 40.0%; 14 cases were mixed infections (more than two subtypes), accounting for 31.1%. EpCAM immunohistochemical expression in 6 cases. Photodynamic therapy clinically cured in 38 cases, 7 cases of recurrence. HPV subtypes (high risk / low risk) were positively correlated with EpCAM positive expression; HPV (mixed / single) infection was not associated with EpCAM positive expression. Adverse reactions: 3 patients complained of vaginal discharge increased, without special treatment, relieve itself after a week. Conclusions Photodynamic therapy is one of the effective treatments for cervical HPV infection. High-risk virus infection is associated with EpCAM expression.