HPV L1壳蛋白在HPV单型感染和多重感染中的表达意义

Expression and significance of HPV L1 shell protein in HPV single infection and multiple infection

目的检测人乳头瘤病毒L1(HPV L1)壳蛋白在各级宫颈病变中的阳性率,同时探讨其在HPV单型感染和多重感染中的表达及意义。方法选取2017年1月至2017年6月,上海市浦东新区人民医院妇科门诊宫颈活检且高危HPV阳性的250例患者,用免疫细胞化学法联合非同位素标记核酸分子杂交技术行HPV L1壳蛋白检测。HPV DNA分型检测采用PCR-反向点杂交法。结果 HPV L1壳蛋白在正常或宫颈炎、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)及宫颈癌(SCC)4组的阳性率分别为21. 6%、52. 8%、22. 2%、0,各组间阳性率差异有统计学意义(P<0. 05)。HPV L1壳蛋白在单型与多重感染的阳性率分别为29. 7%和21. 6%,差异无统计学意义(P>0. 05)。HPV L1壳蛋白在≤35岁、36～49岁及≥50岁3个年龄组阳性率分别为25. 5%、27. 3%、44. 0%,差异无统计学意义(P>0. 05)。结论 HPV L1壳蛋白阳性率在HPV感染中随着宫颈病变级别的加重而下降,可作为宫颈上皮内病变进展的1种预测标志物。HPV L1壳蛋白与HPV感染亚型以及单型或多重感染无明确相关性。

Objective To investigate the positive rate of human papilloma virus(HPV)L1shell protein in cervical lesions at various levels,and to explore the similarities and the differences of its expression and significance in HPV single infection and multiple infection.Methods A total of250high-risk HPV positive cases of cervical biopsy specimens were collected in our gynecological outpatient department from January2017to June2017.Then the HPV L1shell protein was tested by immunocytochemistry combined with non-isotope labeled nucleic acid hybridization.HPV DNA type was detected by polymerase chain reaction(PCR)-reverse dot blot hybridization.Results The positive rates of HPV L1shell protein in normal/inflammation,low-grade squamous intraepithelial lesion(LSIL),high-grade squamous intraepitheliel lesion(HSIL),and squamous cell carcinoma(SCC)groups were21.6%,52.8%,22.2%,and0%,respectively.The difference was statistically significant among the three diseased groups starting from LSIL on(P<0.05).The positive rate of HPV L1shell protein in single and multiple infections was29.65%and21.57%respectively.Although the trend was downward,the difference was not significant(P>0.05).The positive rates of HPV L1shell protein in the three different age groups of35,35-50and>50were25.5%,27.3%and44.0%respectively,and the differences were not statistically significant(P>0.05).Conclusions The positive rate of HPV L1shell protein decreases with the severity level of cervical lesion,which can be used as a predictive marker for indicating the progression of cervical intraepithelial lesions.There was no clear correlation between HPV L1and HPV infection subtypes or single or multiple infections.