Ikenberg H, Wiegering I, Pfisterer J, Kiechle-Schwarz M, Schmitt B, Sauerbrei W, Pfleiderer A
Department of Gynecology and Obstetrics, University of Freiburg, Freiburg, Germany.
Cancer J Sci Am. 1996 Jan-Feb;2(1):28-34.
The medical management of women with cervical carcinoma would benefit from a test that might predict which patients have a high risk of progression or recurrence. The detection of micrometastases in regional lymph nodes may be such a test. At least 90% of cervical carcinomas worldwide contain human papillomavirus (HPV) DNA. In a pilot study, we evaluated a polymerase chain reaction-based method for the detection of human papillomavirus DNA in archival routine sections of regional lymph nodes as a marker of micrometastasis in patients with a long-term follow-up period.
We analyzed 134 archival routine slides of histologically tumor-free lymph nodes derived from 21 patients with clinically and pathologically determined stage Ib, IIa, and IIb HPV-16 positive cervical carcinoma. The patients had been selected for good (still alive with a follow-up time of at least 5 years) or fatal outcome (dead of disease within 3 years). The amount of HPV-16 DNA was estimated by comparison with standards.
All patients without strongly HPV-positive lymph nodes survived. In contrast, 8 of 12 women with strongly HPV-positive lymph nodes died of cervical carcinoma.
In patients with cervical cancer, an approach based on a PCR test for HPV DNA in tumor-free regional lymph nodes may allow early identification of women at high risk for relapse who should receive adjuvant treatment.
对于宫颈癌女性患者的医学管理而言，一种能够预测哪些患者具有高进展风险或复发风险的检测方法将大有裨益。检测区域淋巴结中的微转移可能就是这样一种检测方法。全球至少90%的宫颈癌含有人类乳头瘤病毒（HPV）DNA。在一项初步研究中，我们评估了一种基于聚合酶链反应的方法，用于在区域淋巴结的存档常规切片中检测HPV DNA，以此作为长期随访患者微转移的标志物。
我们分析了来自21例临床和病理确诊为Ib期、IIa期和IIb期HPV - 16阳性宫颈癌患者的134张组织学上无肿瘤淋巴结的存档常规玻片。这些患者被选出来以观察良好（至少存活5年且仍在世）或致命结局（3年内死于疾病）。通过与标准物比较来估计HPV - 16 DNA的量。
所有淋巴结HPV无强阳性的患者均存活。相比之下，12例淋巴结HPV强阳性的女性中有8例死于宫颈癌。
对于宫颈癌患者，基于对无肿瘤区域淋巴结进行HPV DNA聚合酶链反应检测的方法，可能有助于早期识别那些有高复发风险且应接受辅助治疗的女性。
