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目的 :研究非小细胞肺癌(non-small cell lung cancer,NSCLC)患者感染人乳头瘤病毒(human papillomavirus,HPV)的情况,并探讨NSCLC患者感染HPV与表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变间的相关性。方法 :收集98例临床确诊为NSCLC的石蜡组织标本;采用Luminex液相芯片技术对所有标本进行HPV基因的分型,应用突变特异性扩增系统(amplification refractory mutation system,ARMS)检测EGFR基因18~21号外显子突变的情况。结果:98例NSCLC患者中发生HPV感染为25.5%(25/98),其中高危型的为23例,分别是HPV-16、-18、-33和-58亚型;HPV感染在不吸烟者(P=0.036)和淋巴结转移者(P=0.036)中的发生率较高。98例NSCLC患者中EGFR基因突变的检出率为38.8%(38/98),在女性(P<0.001)、不吸烟(P=0.001)、肺腺癌(P=0.001)和临床分期Ⅰ~Ⅱ期(P=0.024)患者中发生率较高。EGFR基因突变的状态与HPV感染显著相关,差异有统计学意义(P=0.012);多因素回归分析结果显示,发生EGFR基因突变的NSCLC患者中HPV感染率较高[危险因素比值(odds ratio,OR)=5.956]。结论 :HPV感染在中国的NSCLC患者中普遍存在,NSCLC中HPV感染与EGFR基因突变存在相关性。
Objective: To investigate the infection of human papillomavirus (HPV) in patients with non-small cell lung cancer (NSCLC) and to investigate the relationship between HPV infection and epidermal growth factor receptor EGFR) gene mutations. Methods: Ninety-eight paraffin-embedded specimens of NSCLC were collected. HPV genotyping was performed on all the specimens using Luminex liquid-phase microarray. The amplification of EGFR gene was detected by amplification refractory mutation system (ARMS) Exon 21 mutations in the situation. Results: HPV infection in 98 NSCLC patients was 25.5% (25/98), of which 23 were in high-risk type, which were HPV-16, -18, -33 and -58 subtypes, respectively; HPV infection in non-smoker (P = 0.036) and lymph node metastasis (P = 0.036). The detection rate of EGFR gene mutation was 38.8% (38/98) in 98 cases of NSCLC patients, and was significantly higher in women (P <0.001), no smoking (P = 0.001), lung adenocarcinoma Patients in stage II (P = 0.024) had a higher incidence. The status of EGFR gene mutation was significantly associated with HPV infection (P = 0.012). Multivariate regression analysis showed that the HPV infection rate was higher in NSCLC patients with EGFR gene mutations (odds ratio, OR) = 5.956]. Conclusion: HPV infection is prevalent in NSCLC patients in China. There is a correlation between HPV infection and EGFR gene mutation in NSCLC.