女性外阴病变及其与HPV16/18、HPV6的相关性

目的研究外阴病变及其与HPV16/18、HPV6的关系。方法收集西安交通大学医学院第二附属医院手术治疗的44例女性外阴病变患者的临床病理资料,包括鳞癌11例,鳞状上皮内瘤变(VIN)10例,尖锐湿疣9例及白色病变14例。采用免疫组化SP方法检测HPV16/18E6蛋白、HPV6L1蛋白的表达。结果①4组外阴病变患者年龄中位数依次为:外阴鳞癌61岁、VIN 45.5岁、尖锐湿疣24岁、外阴白色病44岁,尖锐湿疣组中位年龄低于外阴鳞癌组及白色病变组(P<0.05),其余各组间中位年龄无统计学差异。②HPV16/18E6蛋白在外阴白色病变组、尖锐湿疣组、VIN组及外阴鳞癌组的阳性率分别为2/14、3/9、3/10、8/11,外阴鳞癌组高于白色病变组(P<0.05),其余各组间无统计学差异;HPV6L1蛋白在外阴白色病变组、尖锐湿疣组、VIN组、外阴鳞癌组的阳性率分别为1/14、8/9、4/10、3/11,尖锐湿疣组高于其他各外阴病变组(P<0.05),其余各组间比较差异无统计学意义。③HPV16/18E6蛋白、HPV6L1蛋白在早期外阴鳞癌的阳性率均高于中晚期(P<0.05);HPV16/18E6蛋白、HPV6L1蛋白表达均与外阴鳞癌的组织学分级、年龄分组、绝经情况、产次不相关(P>0.05);HPV16/18E6蛋白与HPV6L1蛋白在外阴鳞癌中的表达不相关(P>0.05)。结论外阴病变的发病与年龄及HPV16/18、HPV6感染有关;外阴鳞癌中HPV16/18、HPV6的感染率与FIGO分期有关,HPV16/18感染率与HPV6的感染率无关。

Correlation of vulvar lesions with HPV16/18 and HPV6

Objective To study vulvar lesion and its relationship with HPV16/18 and HPV6.Methods We collected the clinico-pathological data of 44 vulvar lesion patients who underwent surgical treatment in the Second Affiliated Hospital,Medical School of Xi’an Jiaotong University.Among them,there were 11 cases of squamous cell carcinoma,10 cases of squamous intraepithelial neoplasia,9 cases of genital warts and 14 cases of white lesions.Immunohistochemical SP method was used to detect HPV16/18 E6 and HPV6 L1 protein.Results ① The median age of patients with vulvar lesions: 61 years old in the VSCC vulvar squamous cell carcinoma group,45.5 in the VIN group,24 in the VCA group,and 44 in the white lesions group.It was younger in the VCA group than in the VSCC and white lesions groups(P<0.05).There was no differences in other vulvar lesions groups(P>0.05).② The positive rate of HPV16/18 E6 protein was 2/14 in the white lesions group,3/9 in the VCA group,3/10 in the VIN group and 8/11 in the VSCC group.It was significantly higher in the VSCC group than in the white lesions group(P<0.05);the other groups did not differ significantly.The positive rate of HPV6 L1 protein was 1/14 in the white lesions group,8/9 in the VCA group,4/10 in the VIN group,and 3/11 in the VSCC group.It was higher in the VCA group than in all the other vulvar lesion groups(P<0.05),which had no significant differences(P>0.05). ③ The positive rates of HPV16/18 E6 protein and HPV6 L1 protein were both higher in early squamous cell carcinoma of the vulva than in later stage(P<0.05).The positive rates of HPV16/18 E6 and HPV6 L1 protein were not associated with histological grade,age,menopause or parity(P>0.05).The positive rates of HPV16/18 E6 and HPV6 L1 in vulvar squamous cell carcinoma were not related(P>0.05). Conclusion The incidence of vulvar lesion is associated with age,HPV16/18 and HPV6 infections.HPV16/18 and HPV6 infections in VSCC are both related to FIGO staging.The positive rate of HPV16/18 has no relation with HPV6 in VSCC.