HPV+/-宫颈癌患者临床特点与预后的对比分析

目的:探讨HPV阴性与HPV阳性宫颈癌的临床特点及其和预后的关系。方法:选取住院手术的HPV呈阴性与阳性的宫颈癌患者各86例,且两组患者在年龄、FIGO临床分期相近。分析两组患者的年龄、肿瘤临床分期、病理分型、原发肿瘤大小、分化程度、基层浸润深度、淋巴结转移、治疗方案情况及其5年RFS和总生存时间。结果:两组间宫颈癌患者肿瘤分化程度、肌层浸润深度、淋巴结转移间差异有统计学意义(P0.05)。HPV阳性组和HPV阴性组随访时间分别为63(13~87)个月、61(9~90)个月,5年总生存率分别为70.4%和61.3%,平均总生存时间分别为(73.15±2.74)月和(62.72±3.03)月,差异有统计学意义(p0.05)。HPV阴性组和HPV阳性组5年RFS分别为52.3%和66.4%,平均RFS为(51.57±4.62)月和(58.83±3.46)月,差异有统计学意义(p0.05)。结论:HPV阴性宫颈癌瘤体倾向于低分化,易发生局部侵犯和淋巴结转移,其临床预后较差。

Comparison of Clinical Characteristics and Prognosis between HPV-negative and HPV-positive Cervical Cancer

Objective:To research clinical characteristics and prognosis of the HPV-negative and HPV-positive cervical cancer and the relationship between them.Methods:A retrospective analysis was conducted in this research. 86 patients with cervical cancer and HPV negative were included in this research as HPV negative group. According to principle of 1:1 matching under the rule of age, clinical stage FIGO, 86 patients with cervical cancer and HPV positive were included in this research as HPV positive group. Patient''s age, clinical stage, pathological classification, primary tumor size, differentiation degree, infiltration depth, lymph node metastasis and distant metastasis at the grass-roots level were analyzed, and 5 years RFS and total survival time were compared.Results:Cervical cancer pathological classification, clinical stage, primary tumor size, distant organ metastasis and treatment method between two groups have no statistical difference (P> 0.05). There were statistical differences in tumor differentiation degree, muscular infiltration depth and lymph node metastasis between two groups (P<0.05). The follow-up time of HPV-positive group and HPV-negative group was 63 (13 ~ 87) months and 61 (9 ~ 90) months respectively. The 5-year survival rate of HPV-positive group and HPV-negative group was 70.4%and 61.3%respectively, and the average overall survival was (73.15± 2.74) months and (62.72± 3.03) months, and the differences had statistical significance (P<0.05). RFS of 5 years of HPV-positive group and HPV-negative group was 66.4%and 52.3%respectively, and the average DFS was (58.83 ± 3.46) months and (51.57 ± 4.62) months, and the differences had statistical significance (P<0.05).Conclusion:HPV-negative cervical cancer tend to be poorly differentiated, local invasion and lymph node metastasis, and its clinical prognosis is poorer than that of HPV-positive cervical cancer.