HPV分型与HPVL1蛋白联合检测在判断宫颈疾病预后中的意义

Significance of HPV DNA Type Combined with HPV L1 Capsid Protein Detection in the Prognosis of Cervical Lesions

目的:分析人乳头瘤病毒(HPV)分型与HPV L1蛋白联合检测在判断宫颈疾病预后中的临床意义。方法:选择2011年1月—2012年7月在皖南医学院第一附属医院妇科门诊检测HPV分型高危型阳性,液基薄层细胞学(TCT)检查≥未明确诊断意义的不典型鳞状上皮细胞(ASCUS),最后经组织病理确诊的114例患者作为研究对象,用免疫组化法检测HPV L1蛋白的表达情况,分析HPV亚型、L1蛋白及病理结果之间的关系。结果:在炎症、宫颈上皮内瘤变Ⅰ(CINⅠ)、CINⅡ/Ⅲ和鳞状细胞癌(SCC)中,HPV L1蛋白阳性率分别为64.3%(27/42)、54.5%(6/11)、15.7%(8/51)、0(0/10),HPV L1蛋白阳性率随着宫颈上皮病变加重而逐渐降低(P<0.05)。在114例患者中,HPV16感染阳性最多,占50%(57/114),其次分别为52型(14.91%)、58型(14.04%)、18型(7.89%)。HPV L1蛋白在HPV16和18亚型中呈低表达,在52、58亚型中呈高表达,且在感染HPV52、58亚型患者中L1蛋白阳性组中炎症所占的比例明显高于L1蛋白阴性组中的比例,差异有统计学意义(P<0.05)。结论:HPV L1蛋白的检测有助于判断宫颈疾病的程度及恶性进展趋势,联合HPV分型检测对其预后和处理有一定的指导意义。

Objective：To analyze the relationship between the two methods and pathological results. Methods：Totally 114 patients who had the results of positive high-risk HPV,pathology and thin-prep liquid-based cytology（TCT） test diagnosed of a typical squamous cells of undetermined significance （ASCUS） and above in the First Affiliated Hospital of Wannan Medical College gynecology clinic from January 2011 to July 2012 were analyzed retrospectively. The expression of HPV L1 were detected in cervical lesions. We analyze the relationship between the subtypes of HPV ,HPV L1 capsid protein and pathological results. Results：The positive expression rate of HPV L1 was 64.3%（27/42）,54.5%（6/11）,15.7%（8/51）,0（0/10） in cervictis, CINⅠ,CINⅡ/Ⅲ,SCC,HPV L1 capsid protein expression gradually decreased with cervical lesions increased. The most common HPV subtypes among the 114 patients were HPV16 （50%）,HPV52 （14.91%）,HPV58 （14.04%）,HPV18 （7.89%）, respectively. In the single infection 16 and 18 subtypes of HPV, HPV L1 protein negative rate in L1 protein rate was low expression,but highly expression in 52,58 subtypes. And in cervical tissue infected with HPV52 and HPV58, HPV L1 protein positive expression group finally confirmed by pathology of inflammation was significantly higher than that of negative group （P〉0.05）. Conclusions：The HPV L1 testing is useful in evaluation of cervical lesions and progression risk of cervical dysplasia ,the combination of both HPV L1 and HPV DNA detection can be helpful in management and prognostic prediction.