The Study Of HPV Infection Status And Clinical Value Of The Patients With Special Pathological Type Advanced Stage Cervical Carcinoma After Radical Radiation Therapy

Objective:This project aim to explore the Human Papillomavirus (HPV) infection statusand the risk factors including the residual cancer and lymph vascular space invasion(LVSI) of special pathological type (mainly referring to cervical adenocarcinoma andadenosquamous carcinoma) advanced stage cervical carcinoma after radical radiationtherapyTo assess the clinical significance of surgical treatment for the advanced cervicaladenocarcinoma and adenosquamous carcinoma patients after radical radiationtherapy by analysising the pathological results and survicalTo explore more scientific and reasonable treatment, and to minimize theexcessive or insufficient treatment for the advanced cervical adenocarcinoma oradenosquamous carcinoma..Method:We retrospectively analysised39advanced patients with cervical carcinomatreated at Maternal and Child Health Hospital of Jiangxi Province during the periodbetween Jan2004~Dec2011.we performed the high risk HPVDNA detect for all thepatients using the Hybrid Capture-II (HC-II) Thus proven high-riskHPV infection in advanced cervical adenocarcinoma andadenosquamous carcinoma,From theresults of pathologicalexamination after urgery confirmed that such patientswhether the primary cancer cells is vital or residual disease after receiving radi-cal radiotherapy and chemotherapy. In this study, all the patients were clinical stageIB2and above,the treatment protocols was radical radiation therapy+.surgicaltherapy Radical radiation therapy included external radiation and brachytherapy. Themodus operandi after radiotherapy was the trans-abdominal type II hysterectomy+double Annex resection in6cases, type I hysterectomy+double Annex resection in33cases. We analyzed whether there was residual lesion, metastasis, lymph vascularspace invasion, and whether orificium externum canalis cervicis uteri involved. Results:The detection rate of HPVDNA was100%of the6squamous cervical carcinomapatients, the average load165.12pg/ml. Among the remaining33cases of cervicalcancer17cases(51.5%) was HPV DNA positive, the average load of157.4pg/ml.In6cases of cervical squamous cell carcinoma, no risk factor was detected, thepositive rate is0; a total of23patients with risk factors among the33surgicalspecimens of special histological type cervical carcinoma patients, the positive rate ofrisk factor is69.7%(23/33),Residual cancer in14cases; tumor metastasis in4cases;lesions involving uterus in10cases; lymph vascular space involved in9cases.39patients were followed up from2months to93months, the averagefollow-up period of37.2months, median follow-up period of32months,1caseswere lost after32months following up,27cases survived up to now, the survivaltime was20to93months, the average survival time is47.8months;11patients died,the survival time of the died patients after surgery ranged2to37months, the meansurvival time7months. the average survival time is10.4months.Conclusion：There is significant difference of the positive rate HPVDNA betweenadvancedcervical adenocarcinoma and squamous carcinoma.There is significant difference in the detection rate of pathological risk factorsbetween advanced cervical squamous cell carcinoma and cervical adenocarcinomaafter the same dose radical radiotherapy.It is necessary for the special pathology of advanced cervical carcinoma patientsto perform surgery therapy after radical radiation therapy.