Human Papillomavirus Genotype as a Prognostic Indicator in Carcinoma of the Uterine Cervix
Human Papillomavirus Genotype as a Prognostic Indicator in Carcinoma of the Uterine Cervix
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人乳头瘤病毒基因型作为宫颈癌的预后指标
DOI：
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发表时间：
1989
影响因子：
7.2
通讯作者：
S. Wilczynski
中科院分区：
文献类型：
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作者：
Joan L. Walker;J. Bloss;S. Liao;S. Wilczynski
特定的人乳头瘤病毒（HPV）类型在侵袭性宫颈癌中的临床意义才刚刚开始得到重视。在这一系列的100名宫颈癌妇女中，通过Southern blot杂交分析了HPV 6、11、16、18和31的存在，发现含有HPV 18的肿瘤比含有HPV 16或未发现HPV的肿瘤更具侵袭性。在69例Ib期肿瘤中，肿瘤大小、参数累及或淋巴结转移在肿瘤中含有HPV 16、HPV 18或没有HPV DNA的患者中没有显著差异；然而，在20个月的平均随访期间，45%的含有HPV 18的肿瘤妇女（11人中有5人）复发，相比之下，只有16%的HPV 16（31人中有5人）复发。含有HPV 18的肿瘤的这种复发倾向在所有组织学亚型的宫颈癌和所有级别的肿瘤中都可以看到。此外，与含有hpv16的肿瘤患者相比，含有hpv18的肿瘤患者更有可能提供最近正常的巴氏涂片史。肿瘤中有44%的HPV 18的女性在癌症诊断前的3年内有3次I级帕帕尼科劳涂片的病史，而在肿瘤中有HPV 16的女性中，只有16%的人有类似的病史，这表明含有HPV 18的肿瘤可能在没有长时间侵袭前的情况下进展为侵袭
The clinical implications of specific human papillomavirus (HPV) types in invasive cervical carcinomas are only beginning to be appreciated. In this series of 100 women with cervical cancers analyzed for the presence of HPVs 6,11,16, 18, and 31 by Southern blot hybridization, a more aggressive clinical behavior was demonstrated for tumors containing HPV 18 than for those with HPV 16 or those in which no HPV was identified. Among 69 stage Ib tumors, no significant differences were found in the size of tumor, presence of parametrial involvement, or lymph node metastasis among patients whose tumor contained HPV 16, HPV 18, or no HPV DNA; however, 45% of the women with HPV 18-containing tumors (five of 11) had recurrence, as compared with only 16% of those with HPV 16 (five of 31) during the 20-month mean follow-up period. This tendency for HPV 18- containing tumors to recur was seen with all histologic subtypes of cervical cancers and with all grades of tumor. In addition, patients with HPV 18-containing tumors were more likely to give a history of recent normal Papanicolaou smears than were those whose tumors contained HPV 16. Forty-four percent of women with HPV 18 in their tumors had a history of three class I Papanicolaou smears in the 3 years before the diagnosis of cancer, whereas a similar history was elicited in only 16% of those with HPV 16 in their tumors, suggesting that HPV 18-containing tumors might progress to invasion without a prolonged preinvasive period