Department of Clinical Virology, Christian Medical College, Tamil Nadu, India.
Gynecol Oncol. 2010 Mar;116(3):447-51. doi: 10.1016/j.ygyno.2009.10.081. Epub 2009 Nov 17.
HPV infection is a necessary but insufficient cause of cervical cancer. The significance of HPV DNA in blood however is debatable because of variable detection rates due to the differences in the methodology used. The aim of this study was to detect and quantitate HPV 16 and 18 plasma viremia in women with cervical neoplasia.
HPV DNA was detected in cervical tissue using consensus PGMY primers and genotyped using reverse line blot hybridization. HPV 16 and 18 quantitation in tissue and detection and quantitation in plasma was performed using sensitive real time PCRs targeting E6/E7 region of HPV 16/18 genome respectively. Results were correlated with viral loads in corresponding tissue and with clinical disease stage.
Viremia was detected in 56.4% of HPV 16 positive women and 20% of HPV 18 positive women. The prevalence of HPV 16 DNA in plasma increased with advancing disease stage (p=0.001), although HPV 16 absolute plasma viral load was not significantly associated with advancing disease stage (p=0.281). There was no correlation between absolute plasma viral load and viral load in corresponding cervical tissue (Spearman's rho=0.184, p=0.187). The prevalence of HPV 18 viremia and absolute HPV 18 plasma viral load were not associated with advancing disease stage (p=0.620, p=0.508).
The presence of HPV 16 in plasma is a marker of advancing cervical disease.
HPV 感染是宫颈癌发生的必要但不充分条件。然而，由于所用方法学的差异，血液中 HPV DNA 的意义仍存在争议，因为其检测率存在差异。本研究旨在检测和定量患有宫颈癌前病变妇女的血浆中 HPV16 和 18 型病毒血症。
采用通用 PGMY 引物检测宫颈组织中的 HPV DNA，并采用反向线杂交进行基因分型。采用针对 HPV16/18 基因组 E6/E7 区的敏感实时 PCR 分别检测组织中的 HPV16 和 18 定量以及血浆中的检测和定量。将结果与相应组织中的病毒载量和临床疾病分期相关联。
在 HPV16 阳性的妇女中，有 56.4%检测到病毒血症，在 HPV18 阳性的妇女中，有 20%检测到病毒血症。HPV16 DNA 在血浆中的流行率随着疾病分期的进展而增加（p=0.001），尽管 HPV16 绝对血浆病毒载量与疾病分期的进展没有显著相关（p=0.281）。绝对血浆病毒载量与相应宫颈组织中的病毒载量之间没有相关性（Spearman's rho=0.184，p=0.187）。HPV18 病毒血症的流行率和 HPV18 绝对血浆病毒载量与疾病分期的进展无关（p=0.620，p=0.508）。
HPV16 在血浆中的存在是宫颈癌前病变进展的标志物。
