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目的:探讨人乳头瘤病毒(HPV)在外阴癌中的感染情况、亚型分布及预后情况。方法:选取2012年9月~2014年9月广东省10家医院41例原发性外阴癌患者为研究对象,根据HPV检查结果将其分为HPV阳性组和HPV阴性组。采用流式荧光技术和第二代杂交捕获法(Hc2)对患者病灶表面分泌物分别进行HPV分型及病毒载量检测,并对患者进行随访。结果:41例患者HPV阳性为27例,阳性率为65.85%,外阴癌病理类别中基底细胞癌/疣状细胞癌HPV感染阳性率达到85.71%,HPV阳性组患者年龄小于HPV阴性组,差异有统计学意义(P=0.021)。HPV阳性组中以HPV 16型(88.89%)为主,其次是HPV 52型(18.52%)、HPV 58型(14.81%)等,术后HPV转阴率与术前病毒载量的高低差异无统计学意义(P>0.05)。随访2年内HPV阳性组2例复发,HPV阴性组6例复发,且有1例死亡,两组复发率比较差异有统计学意义(P<0.05)。结论:外阴癌的发生与HPV感染有关,尤其是年轻女性外阴癌,感染亚型以HPV 16型、HPV 52型、HPV 58型为主;与HPV阴性外阴癌比较,HPV阳性的外阴癌预后相对较好。
Objective: To investigate the infection, subtypes and prognosis of human papillomavirus (HPV) in vulvar cancer. Methods: From September 2012 to September 2014, 41 patients with primary vulvar cancer in 10 hospitals in Guangdong Province were selected as the study subjects. According to the HPV test results, they were divided into HPV positive group and HPV negative group. Flow cytometry (FACS) and second-generation hybridization capture (Hc2) were used to detect HPV type and viral load on the surface of patients with lesions, and the patients were followed up. Results: The positive rate of HPV in 41 patients was 27 cases, the positive rate was 65.85%. The positive rate of HPV infection in basal cell carcinoma / verrucous carcinoma in vulvar cancer was 85.71%. The HPV positive group was younger than HPV negative group Statistical significance (P = 0.021). HPV-positive patients were mainly HPV type-16 (88.89%), followed by HPV type-52 (18.52%) and HPV type-58 (14.81%). There was no difference between postoperative HPV negative rate and preoperative viral load Statistical significance (P> 0.05). Two cases of HPV positive group were followed up within 2 years. HPV - negative group had 6 cases relapse and 1 case died. There was significant difference between the two groups (P <0.05). Conclusions: The occurrence of vulvar cancer is related to HPV infection, especially to vulvar cancer in young women. The subtype of infection is mainly HPV type 16, HPV type 52 and HPV type 58. Compared with HPV-negative vulvar cancer, the prognosis of HPV-positive vulvar cancer is relatively better.