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目的研究胃癌组织中HPV16的感染及p21基因突变是否存在协同致癌作用及其与胃癌患者预后的关系。方法采用PCR技术,检测46例胃癌组织标本中HPV16型感染,并采用免疫组化S-P法对胃癌p21基因突变进行检测,所有病例均经三年门诊或书信定期随访。结果HPV 16阳性率为41．30％(19／46),p21阳性表达为52．17％(24／46)。随访发现46例有21例出现复发或远处转移,其中 HPV 16阳性者复发率为73．68％(14／19),p21基因阳性表达者复发率为66．6％(16／24)。值得提出的是二项同时阳性者8例中有 6例出现复发或远处转移。结论HPV16可能是胃癌发生的病因之一,而p21基因失活具有协同致癌作用,亦可作为判断胃癌预后的指标之一。
Objective To investigate whether there is synergistic carcinogenesis of HPV16 infection and p21 gene mutation in gastric cancer and its relationship with the prognosis of patients with gastric cancer. Methods PCR technique was used to detect HPV16 infection in 46 specimens of gastric cancer. The mutation of p21 gene in gastric cancer was detected by immunohistochemical S-P method. All patients were followed up regularly by three years outpatient service or epistaxis. Results The positive rate of HPV16 was 41.30% (19/46) and the positive rate of p21 was 52.17% (24/46). Follow-up was found in 46 cases of 21 cases of recurrence or distant metastasis, including HPV16-positive recurrence rate was 73.68% (14/19), p21 gene positive expression of the recurrence rate was 66.6% (16/24). It is worth mentioning that there are 6 cases of recurrence or distant metastasis in 8 of 8 cases with positive results at the same time. Conclusion HPV16 may be one of the causes of gastric cancer. However, inactivation of p21 gene has a synergistic carcinogenic effect and may be used as an indicator of prognosis of gastric cancer.