宫颈糜烂及HPV16/18 E6的表达关系研究

Relationship between Cervical Erosion and HPV16/18 E6 Expression

目的:研究肉眼拟诊为宫颈糜烂的患者其组织学诊断及人乳头瘤病毒16型(或18型)E6蛋白(HPV16/18E6)的表达及其临床意义。方法:随机抽取年龄为18～65岁的肉眼观为宫颈糜烂的患者100例,分为宫颈轻度糜烂组(30例)、中度糜烂组(41例)、重度糜烂组(29例),光滑组100例(对照组)。分别行阴道镜下宫颈活检,作出病理组织学诊断,采用免疫组织化学法(SP法)测定宫颈组织中HPV16/18E6表达情况。结果:(1)各组宫颈活检的病理结果分为正常、宫颈炎、宫颈上皮内瘤样病变(CIN)Ⅰ、CINⅡ、CINⅢ及宫颈癌(Ca)。各组间疾病构成差异有统计学意义(P<0.01),且CINⅡ、CINⅢ及Ca随着疾病严重程度亦呈增加趋势。(2)宫颈光滑组、轻度糜烂组、中度糜烂组及重度糜烂组的HPV16/18E6蛋白阳性率分别为21.0%、26.7%、31.7%及51.6%,差异有统计学意义(P<0.01)。其中,光滑组与轻度糜烂组及中度糜烂组、轻度糜烂组与中度糜烂组阳性率差异无统计学意义(均P>0.05);重度糜烂组与其他各组比较差异有统计学意义(P<0.05或P<0.01)。结论:肉眼拟诊为宫颈糜烂的患者其组织学诊断多样化,糜烂程度越高,发生宫颈上皮内瘤变及宫颈癌的可能性越大,HPV16/18E6的表达水平亦有随之升高的趋势。

Objective： To investigate the pathology diagnosis and the expression of human papillomavirns type 16/18 （HPV16/18）E6 protein in patients diagnosed as cervical erosion by clinical manifestations. Methods： One hundred patients aged 18-65 with cervical erosion were randomly selected and divided into minor erosion group （n=30）,moderate erosion group （n=41）,serious erosion group（n=29）and smooth group （n=100）. The histopathological diagnosis of cervical erosion was made by cervical biopsy. The expression of HPV16/I$ E6 protein of cervical tissues was detected by immunohistochemistry. Results： （1） The pathological diagnose results were normal, cervical inflammation, cervical intraepithelial neoplasia （CIN）I,CINⅡ ,CINⅢand cervical cancer （Ca） for each group. The differences of consitituent ratios in each group were statistically significant （P 〈 0.01）, and CIN Ⅱ ,CIN Ⅲ and Ca were found in an increasing trend with the severity of diseases.（2）The positive rates of HPV16/18 E6 immunohistochemistry expression were 21.0%,26.7%,31.7% and 51.6% in smooth group,minor erosion group, moderate erosion group and serious erosion group,and differences were statistically significant （P 〈 0.01）.There was no signifi- cant difference in the positive rate between minor erosion group and smooth group,and also no significant difference in the pos- itive rate between minor erosion group and moderate erosion group（P 〉 0.05）.There were significant differences in positive rates between serious erosion group and other groups （P 〈 0.05 or P 〈 0.01）. Conclusion： Patients diagnosed as cervical ero- sion by clinical manifestations showed a diversification in histological patterns. The higher the degree of erosion, the greater the possibility of occurrence of cervical intraepithelial neoplasia and cervical cancer. The expression level of HPV16/18 E6 was also increased.