宫颈癌及癌前病变中的HPV-16整合人宿主基因组的发生情况及其在宫颈癌筛查中的应用

Integrated State of HPV-16 in Precancerous Tissues and Cervical Cancer and Application in Cervical Cancer Screening

目的:探讨人类乳头瘤病毒16型(HPV-16)在宫颈癌及宫颈癌前病变患者中与宿主基因组的整合情况。方法:选取宫颈癌变组织252例,其中48例为宫颈癌组织,204例为宫颈上皮内瘤样病变组织(CIN),其中包括125例CINⅠ,46例CINⅡ,33例CINⅢ作为研究组;另外选取20例因子宫肌瘤行全子宫切除术的正常宫颈上皮组织作为对照组。对各标本采用定量PCR检测法检测HPV-16病毒的整合状态。结果:与正常的宫颈上皮组织相比,宫颈病变组织均发生了HPV-16病毒感染且与宿主基因整合的情况。其中宫颈癌组织的整合率最高,而CIN组织中随着病变程度的加重HPV-16病毒的整合率也增高,差异有统计学意义(χ2=49.7359、12.6033,P均<0.01)。结论:宫颈病变的严重程度可能与HPV-16的整合感染有关,在HPV DNA检测的基础上联合对高危HPV整合感染状态进行检测有利于提高宫颈癌筛查准确率并在早期预测宫颈病变的转归。

Objective: To investigate the prevalence of physical state of HVP-16 DNA in cervical and cervical precancerous carcinoma. Method: Multiplex PCR was adopted to detect the physical state of HPV in samples from 252 patients with cervical carcinoma,including 48 samples of cervical cancer,204 cervical intraepithelial( CIN)( 125 CIN I,46 CIN Ⅱ and 33 CIN Ⅲ) and 20 normal samples from the subjects with hysteromyoma undergoing hysterectomy,respectively. Result: Not only patients with cervical cancer but also patients with precancerous were found to have integrated infection with HPV-16 and those with cervical cancer have the highest integration rate. With the elevating of the grades of CIN,the integrated infection rates of HVP-16 was significantly elevated,the difference was statistically significant( χ2= 49.7359,12.6033,P < 0.01).Conclusion: Among the patients with HPV-16 infection,the integrated state of HVP-16 is positively correlated with the severity of cervical lesions. Combined HVP typing test and detection of integrated viral contribute to predicting the prognosis of patients with cervical precancerous lesions and increasing the accuracy of screening cervical cancer on the basis of HPV DNA detection.