Nestin表达及高危型HPV感染与宫颈病变相关性的研究

Correlation between Nestin Expression and High risk-HPV infection in Cervical lesions

目的:研究不同宫颈病变中巢蛋白(Nestin)的表达与高危型人乳头瘤病毒(HR-HPV)感染的关系及临床意义。方法:选取2015年5月～2017年12月宫颈病变患者300例,以病理诊断为金标准,分为慢性宫颈炎45例,CINⅠ74例,CINⅡ65例,CINⅢ68例,宫颈癌48例,采用PCR-反向点杂交法检测HPV基因型别,同时对其中150例(20例慢性宫颈炎,25例CINⅠ,27例CINⅡ,30例CINⅢ,宫颈癌48例)用免疫组化法检测Nestin蛋白表达情况,分析Nestin蛋白表达与HR-HPV之间的关系及其与宫颈病变的相关性。结果:(1)慢性宫颈炎组HR-HPV阳性率33. 33%,明显低于CINⅠ71. 62%、CINⅡ80. 00%、CINⅢ92. 65%、宫颈癌95. 83%,差异有统计学意义(P<0. 01)。HR-HPV阳性率随着慢性宫颈炎、CINⅠ～Ⅱ、CINⅢ宫颈癌的病理组织学诊断升级而升高,差异有统计学意义(P <0. 05)。(2)Nestin蛋白阳性表达率在慢性宫颈炎、CINⅠ～Ⅲ及宫颈癌各组分别为25. 00%、28. 00%、51. 85%、63. 33%%及83. 33%,呈逐渐升高趋势,差异有统计学意义(P <0. 01)。(3)除慢性宫颈炎组外,CINⅠ～Ⅲ及宫颈癌各组Nestin表达与HR-HPV感染具有相关性(P <0. 05)。结论:宫颈癌及癌前病变中Nestin表达及HR-HPV感染具有相关性,提示两者联合检测对评估宫颈病变预后及早期防治宫颈癌具有重要意义。

Objective： To study the relationship between the expression of Nestin and high risk-human papilloma virus（HR-HPV） in different cervical lesions and its clinical significance. Methods： 300 patients complied with the histopathological diagnostic standards were selected in our hospitals from May 2015 to December 2017.They were divided into five groups： 45 chronic cervicitis,74 CINⅠ,65 CINⅡ, 68CINⅢand 48 cerical cancer. HPV genotypes were detected by PCR-reverse dot hybridization, while 150 cases （20 chronic cervicitis, 25 CINⅠ, 27 CINⅡ, 30 CINⅢand 48cervical cancer） with immunohistochemical method to detect Nestin protein expression. The relationship between Nestin expression and HR-HPV and its correlation with cervical lesions were analyzed. Results： ①The HR-HPV positive rate in the chronic cervicitis group was 33.33%, significantly lower than CINⅠ 71.62%, CIN Ⅱ 80.000%, CINⅢ 92.65%, and cervical cancer 95.83%, with statistically significant difference （ P 〈0.01）,which increased with the histological diagnosis upgrading（cervicitis, CINⅠ~Ⅱ、CINⅢ-cervical cancer） （ P 〈0.05）.②The positive expression rate of Nestin protein was 25.00%, 28.00%, 51.85%, 63.33% and 83.33% in chronic cervicitis, CINⅠ~Ⅲ and cervical cancer group respectively, showing a gradually increasing trend, with statistically significant difference （ P 〈0.01）. ③Except for the chronic cervicitis group, Nestin expression of CINⅠ~Ⅲ and cervical cancer were correlated with HR-HPV infection （ P 〈0.05）. Conclusions： Nestin expression and HR-HPV infection are correlated in cervical cancer and precancerous lesions, suggesting that combined detection will be of great significance to evaluate the prognosis of cervical lesions and early prevention and treatment of cervical cancer.