CAJ | 학술논문

目的探讨人乳头瘤病毒(HPV)与阴茎癌临床病理参数之间的相互关系以及其对阴茎癌的预后判断价值.方法收集2000至2009年北京大学肿瘤医院、卫生计生委北京医院、北京大学人民医院诊断为阴茎癌的患者共28例,回顾性分析患者的临床病理资料,应用PCR技术检测阴茎癌组织中HPV感染情况.对患者进行规律随访,将随访资料与临床病理参数、HPV DNA进行Kaplan-Meier生存分析和Cox回归分析,计算疾病特异性生存率.结果 28例阴茎癌患者癌组织中有7例患者扩增出了HPV DNA,均为HPV-16型.患者随访6～150个月,中位随访60个月,28例患者中8例死于阴茎癌.患者年龄、病理分级、病理分期和淋巴结状况与HPV DNA无明显相关性(P=0.191、0.165、1.000、0.639).多因素Cox回归分析显示:病理T分期(HR=11.0,P=0.035)和淋巴结状态(HR =5.5,P=0.023)与阴茎癌患者5年疾病特异性生存率显著相关,是其预后独立变量.HPV DNA阳性组患者的5年生存率虽高于HPV DNA阴性组患者(67％比58％),但差异无统计学意义(P=0.431).结论病理分期和淋巴结转移是阴茎癌患者独立的预后不良因素,HPV DNA阳性不会增加阴茎癌患者的病死率.
목적 탐토인유두류병독(HPV)여음경암림상병리삼수지간적상호관계이급기대음경암적예후판단개치.방법 수집2000지2009년북경대학종류의원、위생계생위북경의원、북경대학인민의원진단위음경암적환자공28례,회고성분석환자적림상병리자료,응용PCR기술검측음경암조직중HPV감염정황.대환자진행규률수방,장수방자료여림상병리삼수、HPV DNA진행Kaplan-Meier생존분석화Cox회귀분석,계산질병특이성생존솔.결과 28례음경암환자암조직중유7례환자확증출료HPV DNA,균위HPV-16형.환자수방6～150개월,중위수방60개월,28례환자중8례사우음경암.환자년령、병리분급、병리분기화림파결상황여HPV DNA무명현상관성(P=0.191、0.165、1.000、0.639).다인소Cox회귀분석현시:병리T분기(HR=11.0,P=0.035)화림파결상태(HR =5.5,P=0.023)여음경암환자5년질병특이성생존솔현저상관,시기예후독립변량.HPV DNA양성조환자적5년생존솔수고우HPV DNA음성조환자(67％비58％),단차이무통계학의의(P=0.431).결론 병리분기화림파결전이시음경암환자독립적예후불량인소,HPV DNA양성불회증가음경암환자적병사솔.
Objective To examine the prevalence of human papilloma virus (HPV) in penile squamous-cell carcinomas (SCCs),explore the relationship between HPV and clinicopathological variables and determine its value for predicting disease-specific survival.Methods We retrospectively collected clinicopathological data of 28 patients with penile squamous cell carcinomas from 2000 to 2009 at Beijing Cancer Hospital,Beijing Hospital and Peking University People's Hospital.Polymerase chain reaction (PCR) was used to detect the presence of HPV DNA in tumor specimens.Regular follow-ups were conducted.Disease-specific survival plots were drawn with the Kaplan-Meier method and compared with the Log-Rank test.Cox proportional hazard analysis was applied to assess the independent effects of several prognostic factors on survival.Results HPV DNA was detected in 7/28 samples.After sequencing,all 7 samples were confirmed to be HPV-16 type.The median follow-up period was 60(6-150)months.By the time of analysis,8/28 patients died.HPV DNA was not significantly associated with age,pathological grading,pathologic T stage or lymph node metastasis (P =0.191,0.165,1.000,0.639 respectively).Cox multivariate regression analysis indicated that lymph node status(HR =5.5,P =0.023)was an independent predictive factor of disease specific survival,followed by pathological T classification (HR =11.0,P =0.035).The 5-year disease-specific survival in patients with HPV DNA positive was higher than that in those with HPV DNA negative(67％ vs 58％).But survival had no significant differences (P =0.431).Conclusions Higher pathologic T stage and lymph node metastasis are independent prognostic factors for worse survival.And mortality does not increase markedly in penile cancer patients with HPV DNA positive.