Department of Woman and Child Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, Sweden.
Gynecol Oncol. 2010 May;117(2):312-6. doi: 10.1016/j.ygyno.2009.12.031. Epub 2010 Feb 6.
To investigate the presence of HPV in VSCC and sentinel nodes (SN) in patients in Sweden and the possible influence of HPV on prognosis.
Primary tumors from 75 VSCC patients undergoing the SN procedure and SNs from 69 patients were tested for HPV DNA. Analyses were performed by PCR using general (GP5+/6+ and CPI/IIG) type-specific primers, and sequencing in paraffin-embedded VSCC and SN.
HPV was detected in 23/75 (31%) of the tumors and in 10/23 (43%) of the SNs in patients with HPV-positive tumors and in one SN of a patient with an HPV-negative tumor. Patients with HPV-positive VSCC were younger at diagnosis (p<0.001) and had better survival (p=0.030), adjusted for age and lesion size, than those with HPV-negative tumors. In patients with HPV-positive tumors, SNs with metastases were more frequently HPV positive (5/5) than those without metastases (5/18) (p=0.007).
The rate of 31% HPV-positive VSCC in Sweden is similar to other reports. As far as we know, HPV in SN in VSCC never been investigated previously. The differences in age, tumor size, prevalence of HPV in SN and survival of patients with HPV-positive and negative VSCC support the assumption that VSCC develops through two different pathways, with better survival for patients with HPV-positive tumors. Presence of HPV DNA in SN was related to metastatic disease but did not affect survival in this study.
研究 HPV 在瑞典 VSCC 患者中的存在情况以及前哨淋巴结 (SN) ，并探讨 HPV 对预后的可能影响。
对 75 例接受 SN 手术的 VSCC 患者的原发肿瘤和 69 例患者的 SN 进行 HPV DNA 检测。采用通用 (GP5+/6+ 和 CPI/IIG) 型特异性引物进行 PCR 分析，并对石蜡包埋的 VSCC 和 SN 进行测序。
HPV 在 23/75（31%）例肿瘤和 10/23（43%）例 HPV 阳性肿瘤患者的 SN 中检测到 HPV。HPV 阳性 VSCC 患者的诊断年龄更年轻（p<0.001），且生存情况更好（p=0.030），调整年龄和病变大小后。HPV 阳性肿瘤患者中，转移的 SN 更常呈 HPV 阳性（5/5），而非转移的 SN 则较少呈 HPV 阳性（5/18）（p=0.007）。
瑞典 HPV 阳性 VSCC 的发生率为 31%，与其他报道相似。据我们所知，HPV 在 VSCC 的 SN 中从未被研究过。HPV 阳性和阴性 VSCC 患者在年龄、肿瘤大小、SN 中 HPV 阳性率和生存率方面的差异支持这样一种假设，即 VSCC 通过两种不同途径发展，HPV 阳性肿瘤患者的生存率更好。本研究中，SN 中存在 HPV DNA 与转移性疾病有关，但并未影响患者的生存。
