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术前HR-HPV阳性、载量及SCC-Ag阳性对宫颈癌根治术后复发率的影响 被引量:12

Effect of HR-HPV positive,load and SCC-Ag positive on recurrence rate after radical resection for cervical cancer
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摘要 目的探讨高危型人乳头瘤病毒(HR-HPV)阳性、HR-HPV载量及鳞状上皮细胞癌抗原(SCC-Ag)阳性对宫颈癌根治术后复发的影响。方法回顾性分析2010年1月至2019年1月在广州市增城区人民医院接受宫颈癌根治术治疗的宫颈癌患者临床资料,术后定期随访,检测患者术前HR-HPV阳性、载量及SCC-Ag表达情况,并统计患者宫颈癌复发及转移情况,分析HR-HPV阳性、HR-HPV载量及SCC-Ag联合预测宫颈癌复发及转移的价值。结果共纳入研究438例宫颈癌患者。复发组(42例)与未复发组(396例)比较,在病理类型、术后MeigsBrunschwig病理分期方面,差异无统计学意义(P>0.05)。复发组与未复发组比较,在HR-HPV阳性比例[(40/42)vs.(144/396)]、不同HR-HPV载量比例[(8/10/24)vs.(192/154/50)]、SCC-Ag阳性比例[(34/42)vs.(64/396)]方面,差异均具有统计学意义(P<0.05)。盆腔复发与远处转移相比,HR-HPV阳性存在差异,且具有统计学意义(P<0.05);而HR-HPV载量与SCC-Ag差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,远处转移、宫颈癌FIGO分期、HR-HPV阳性、SCC-Ag是影响宫颈癌复发的独立危险因素(P<0.05)。单独指标预测时,HRHPV阳性预测宫颈癌复发的特异度和阳性预测值最高为99.18%、95.23%,HR-HPV载量阴性预测值最高为87.37%,SCC-Ag预测宫颈癌复发的灵敏度最高为33.33%,联合预测时灵敏度为64.51%,特异度为99.46%,阳性预测值为97.41%,阴性预测值为94.44%。结论远处转移、FIGO分期、HR-HPV阳性、SCC-Ag是影响宫颈癌复发的独立危险因素,HR-HPV阳性、HR-HPV载量以及SCC-Ag联合检测对预测宫颈癌复发有一定价值,3种指标联合检测预测价值提高。 Objective To investigate the effect of HR-HPV positive,HR-HPV load and SCC-Ag positive on the recurrence of cervical cancer after radical resection.Methods The clinical data of cervical cancer patients who underwent radical resection of cervical cancer in People’s Hospital of Zengcheng District from January 2010 to January2019 were retrospectively collected.The patients were followed up regularly,and the preoperative HR-HPV positive,loading,the amount of SCC-Ag expression were determined;the recurrence and metastasis of cervical cancer were analyzed,and the value of HR-HPV positive,HR-HPV loading and SCC-Ag in predicting the recurrence and metastasis of cervical cancer were analyzed.Results A total of 438 patients with cervical cancer were included.There was no significant difference in pathological type,or postoperative Meigs-Brunschwig pathological staging between the recurrence group(n=42)and the non-recurrence group(n=396)(P>0.05).The difference in the proportion of HRHPV positive(40/42 vs. 144/396),HR-HPV loading and SCC-Ag positive(34/42 vs. 64/396)was statistically significant between non-recurrence group and recurrence group(P<0.05).The difference in HR-HPV positive in pelvic recurrence and distant metastasis was statistically significant(P<0.05).There was no significant difference in HR-HPV load or SCC-Ag in pelvic recurrence and distant metastasis(P>0.05).Multivariate logistic regression analysis showed that distant metastasis,FIGO staging of cervical cancer,HR-HPV positive,and SCC-Ag were independent factors affecting cervical cancer recurrence(P<0.05).When predicting by individual indicator,the specificity and positive predictive value of HR-HPV positive for predicting cervical cancer recurrence were 99.18% and 95.23% at the highest,and the negative predictive value of HR-HPV was87.37% at the highest.When SCC-Ag was used to predict cervical cancer recurrence,the sensitivity was up to 33.33%.The sensitivity of combined prediction was 64.51%,the specificity was 99.46%,the positive predictive value was
作者 曾杰 罗国贤 黄键宁 区林伟 张琼花 吴嘉俊 郭诗月 ZENG Jie;LUO Guo-xian;HUANG Jian-ning;OU Lin-wei;ZHANG Qiong-hua;WU Jia-jun;GUO Shi-yue(Department of Obstetrics and Gynecology,People's Hospital of Zengcheng District,Guangzhou 511300,China)
出处 《中国实用妇科与产科杂志》 CAS CSCD 北大核心 2019年第11期1239-1243,共5页 Chinese Journal of Practical Gynecology and Obstetrics
关键词 宫颈肿瘤 高危型人乳头瘤病毒 高危型人乳头瘤病毒载量 鳞状上皮细胞癌抗原 cervical neoplasm high-risk human papillomavirus high-risk human papillomavirus load squamous cell carcinoma antigen
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