宫颈癌及癌前病变中的HPV-16的整合感染状态

Integrated infection status of HPV-16 in cervical cancer and precancerous lesions

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基因组的整合情况。方法选取2012年2月至2014年12月在浙江省医疗健康集团杭州医院经活检后宫颈癌变组织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),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(χ~2值分别为49.7359、12.6033,均P<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 integration of human papillomavirus type 16（HPV-16）in cervical cancer and precancerous lesions with host genome.Methods Totally 252 cases of cervical cancer were selected from February 2012 to December 2014 in Hangzhou Hospital of Zhejiang Medical and Health Group,including 48 samples of cervical cancer and 204 samples of cervical intraepithelial neoplasia（CIN）（125 CIN Ⅰ,46 CIN Ⅱ,33 CIN Ⅲ）in study group.Another 20 normal samples from subjects with hysteromyoma undergoing hysterectomy were taken as control group.Qualitative PCR method was used to detect the integration of HPV-16.Results Compared with normal cervical epithelial tissue,HPV-16 infection and integration with host genome occurred in all the cervical lesions.Integration rate of cervical cancer tissues was highest.With the increasing of the grades of CIN,the integration rates of HVP-16 elevated significantly,and the difference was statistically significant（χ~2 value was 49.7359 and 12.6033,respectively,P〈0.01）.Conclusion The severity of cervical lesions is probably correlated with integrated infection of HVP-16.Based on HPV DNA detection,detecting HPV integrated infection status contributes to improving accuracy of screening cervical cancer and predicting the prognosis of cervical precancerous lesions at early stage.