Brn-3a在宫颈病变中的表达及其与HPV亚型的相关性研究

Brn-3a expression in cervical neoplasia and its relationship with HPV subtypes

目的:初步探讨Brn-3a在HPV所致各级别宫颈病变中的表达及不同HPV亚型与Brn-3a表达的关系,探讨其作为CIN诊断和治疗标志物的可行性。方法:按照入组标准选取研究期间在我院就诊的月经正常、有性生活史的妇女97例为研究对象。对同一位患者的宫颈脱落细胞同时进行转录因子Brn-3a的表达及HPV分型的检测。分析每组样本Brn-3a的表达。结果:Brn-3a表达随着病变加重而升高。高级别CIN(CINⅡ、Ⅲ及原位癌)LEEP术后随访组Brn-3a表达高于宫颈良性病变(HPV-)组,差异有统计学意义(P=0.0000,<0.05);该组平均值虽高于HPV感染(HPV+)、宫颈湿疣与CINⅠ组,但二者无统计学差异(P=0.6815,>0.05);与高级别CIN组(治疗前)相比,表达量明显减少,差异有统计学意义(P=0.0002,<0.05)。不同HPV亚型所致的同级别病变中Brn-3a表达差异无统计学意义;高危型和低危型HPV感染所致的CINⅠ以下病变组中,Brn-3a表达无统计学差异(P=0.5815);同种HPV亚型所致的不同病变级别Brn-3a表达有统计学差异。结论:转录因子Brn-3a表达与HPV所致宫颈病变的病理级别相关,并非简单的反映HPV的感染状态。

Objective：To determine the expression of cellular transcription factor Brn-3a in different levels of cervical lesions caused by various subtypes of HPV, and to explore its potential as a diagnostic and treatment marker. Methods：Cervical smears from 97 women with cervical lesions were collected according to predefined standard. Every sample was tested and analyzed for Brn-3a expression and HPV subtypes. Results ：The quantified level of Brn-3a corresponded to the severity of the cervical lesions. Brn-3a expression in the CIN Ⅱ,Ⅲ after LEEP was statistically higher than that in chronic cervicitis （ HPV - ） （P = 0. 0000, 〈 0.05 ） and lower than untreated high grade group （ P = 0. 0002）, but its discrepancy with the HPV infection, cervical condiloma and CIN I was not statistically significant（ P = 0. 6815 ）. No statistically signifi- cant difference was found in Brn-3a level between diverse HPV subtypes in the same degree of cervical lesions, or between high risk and low risk subtypes of HPV （P = 0. 5815 ） when analyzed as a whole in ≤ CIN I lesions which was the only group infected by both high and low risk types of HPV. While in different degrees of cervical lesions infected with the same subtype of HPV, the expression of Brn-3a varied significantly. Conclusion： The expression of Brn-3a relates positively to histopathology, and does not vary significantly according to different HPV subtypes in the same degree of cervical lesion.