子宫颈细胞人乳头瘤病毒 L1壳蛋白的表达与临床应用研究

Expression of human papillomavirus L1 capsid protein in cervical cells and its clinical application

目的:探讨子宫颈细胞人乳头瘤病毒(HPV)L1壳蛋白的表达对宫颈细胞恶性转化及细胞免疫的影响,解析针对宫颈癌进行HPV L1壳蛋白检测的临床应用价值。方法:收集鹰潭市人民医院2012年7月~2014年12月期间在妇科门诊就诊妇女280例,对所有入组人员进行液基细胞学检查(LCT),同时,应用赛泰细胞/组织HPV检测试剂盒对L1壳蛋白进行免疫细胞化学染色以检测脱落细胞中HPV L1壳蛋白的表达,采用Cervista HPV检测系统进行HPV检测,将宫颈活检病理学结果作为基线进行比较,按照病变不同程度分为上皮内病变阴性(NILM)、非典型性鳞状上皮细胞(ASC)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)和鳞状上皮癌(SCC)5组,对比分析HPV L1壳蛋白表达在不同程度病变中的阳性表达率情况。采用ELISA检测细胞中白细胞介素2(IL-2)及肿瘤坏死因子α(TNF-α)的水平,利用流式细胞术检测血清细胞中免疫细胞亚群的情况。结果:HPV L1壳蛋白阳性率随着宫颈活检确定的宫颈病变级别的加重而呈现下降趋势,在SCC中的表达为0。各组间HPV L1壳蛋白阳性表达率的差异具有统计学意义(P<0.05);IL-2水平随着HPV L1壳蛋白表达阳性率升高而减少,TNF-α水平随着HPV L1壳蛋白表达阳性率升高而增加(P<0.05);HPV L1壳蛋白阳性表达伴随着免疫激活性细胞亚群的减少,免疫抑制性免疫细胞群体的增加(P<0.05),且具有强相关性。结论:子宫颈细胞HPV L1壳蛋白表达的检测对于判断宫颈细胞恶性转化以及机体细胞免疫状态具有良好的应用价值,值得临床上加以应用。

AIM:To investigate the effect of human papillomavirus(HPV)L1 capsid protein on the malignant transformation and cellular immunity of cervical cells,and to analyze the clinical application value of HPV L1 capsid protein detection in cervical cancer.METHODS:The data and samples of 280 women in the Gynaecology Clinic were collected from Yingtan People’s Hospital from July 2012 to December 2014.All patients were enrolled for liquid-based cytology test(LCT).At the same time,the protein expression of HPV L1 in exfoliated cells was detected by CytoReact cell/tissue L1 capsid immunocytochemical staining.The Cervista HPV detection system was used for HPV detection,and the pathological results of cervical biopsy were used as a baseline for comparison.According to the degree of lesions,the tissues were divided into 5 groups:negative intraepithelial lesion(NILM)group,atypical squamous cell(ASC)group,low-grade squamous intraepithelial lesion(LSIL)group,high-grade squamous intraepithelial lesion(HSIL)group,and squamous-cell carcinoma(SCC)group.The positive expression rates of HPV L1 protein in different degrees of lesions were compared and analyzed.The levels of interleukin-2(IL-2)and tumor necrosis factor-α(TNF-α)in the cells were detected by ELISA.Flow cytometry was used to analyze the immune cell subsets in the blood.RESULTS:The positive rate of HPV L1 capsid protein was decreased with the severity of cervical lesions determined by cervical biopsy,and was 0 in SCC group.The positive expression rate of HPV L1 capsid protein in each group was statistically different(P<0.05).The level of IL-2 was decreased with the increase in HPV L1 capsid protein expression,and the level of TNF-αwas increased with the increase in HPV L1 capsid protein expression with statistical significance(P<0.05).The positive expression of HPV L1 capsid protein was accompanied by the decrease in immune-activated cell subsets,and the increase in immunosuppressive immune cell population with statistical significance(P<0.05),and the strong correlation was observed.CONCLUSION:The detection of HPV L1 capsid protein expression in cervical cells is highly applicable for judging the malignant transformation and the cellular immune status of the cells,which is worthy of clinical use.