General Teaching Hospital and 1st Medical School of Charles University, Department of Oncogynecology, Apolinarska 18, 128 00 Prague 2, Czech Republic.
J Clin Virol. 2011 Jan;50(1):46-9. doi: 10.1016/j.jcv.2010.09.020. Epub 2010 Oct 28.
Paraaortic lymph nodes represent the second level in the lymphatic spread of cervical cancer. Recent studies have confirmed the association of HPV DNA in pelvic lymph nodes in early-stage disease with metastatic involvement and a less favourable prognosis.
The aim of our study was to detect 13 high-risk genotypes of HPV in paraaortic nodes harvested from patients with FIGO IB2-IIIB tumours and correlate findings with histopathology.
The study involved patients with advanced cervical cancer who had undergone low paraaortic lymphadenectomy. The cytobrush technique was used for perioperative sample collection from the tumour and fresh lymphatic tissue. Patients with non-HPV related cancers were used as a control group.
The study involved 24 cervical cancer patients. High-risk HPV DNA was found in the primary tumour of all cases and in PALN in 16 (67%) cases. The most frequent genotype was HPV 16, both in the tumour and in the paraaortic lymph nodes (83% and 54%, respectively). Metastatic involvement of paraaortic lymph nodes was identified in 8 cases (33%), which all were also HPV DNA positive. No HPV DNA was detected in PALN in any of 22 control group cases.
Using the cytobrush technique, the presence of at least one HR HPV genotype in the primary tumour was identified in all the patients. The metastatically involved paraaortic lymph nodes always contained the DNA of at least one HPV genotype present in the primary tumour. Determination of clinical significance of HR HPV DNA presence in histologically negative lymph nodes requires further follow-up of the cohort.
腹主动脉旁淋巴结是宫颈癌淋巴转移的第二站。最近的研究证实，早期宫颈癌患者盆腔淋巴结中 HPV DNA 的存在与转移受累和预后较差相关。
本研究旨在检测 FIGO IB2-IIIB 期肿瘤患者腹主动脉旁淋巴结中 13 种高危型 HPV，并将检测结果与组织病理学相关联。
本研究纳入了接受低水平腹主动脉旁淋巴结切除术的晚期宫颈癌患者。使用细胞刷技术在围手术期从肿瘤和新鲜淋巴组织中采集样本。非 HPV 相关癌症患者被用作对照组。
本研究共纳入 24 例宫颈癌患者。所有病例的原发肿瘤中均发现高危型 HPV DNA，16 例（67%）患者的腹主动脉旁淋巴结中也发现高危型 HPV DNA。最常见的基因型是 HPV 16，在肿瘤和腹主动脉旁淋巴结中分别为 83%和 54%。8 例（33%）患者的腹主动脉旁淋巴结发生转移，这些患者的腹主动脉旁淋巴结均为 HPV DNA 阳性。22 例对照组患者的腹主动脉旁淋巴结均未检测到 HPV DNA。
使用细胞刷技术，在所有患者的原发肿瘤中均检测到至少一种高危型 HPV 基因型的存在。转移受累的腹主动脉旁淋巴结总是包含原发肿瘤中存在的至少一种 HPV 基因型的 DNA。确定组织学阴性淋巴结中 HR HPV DNA 存在的临床意义需要进一步对该队列进行随访。
