宫颈组织α辅肌动蛋白4表达与HPV载量及病变程度的相关性

The expression of α-actinin 4 in cervical cancer and the correlation with high-risk human papilloma virus infection

目的探讨α辅肌动蛋白4(ACTN4)在宫颈上皮内瘤变及宫颈癌组织中的表达,及其与高危型人乳头瘤病毒(HR-HPV)感染的相关性。方法选取2014年6月至2015年2月期间就诊于山西医科大学第二临床医院妇科门诊,经宫颈活检及手术切除的宫颈组织病理标本120例,其中CINⅠ、CINⅡ、CINⅢ、早期宫颈鳞癌(Ia-IIa期)患者各30例,同时选择同期阴道镜门诊检查并且病理诊断正常的30例患者作为对照组:采用免疫组化法检测ACTN4在不同宫颈组织中的表达情况,同时采用HC-Ⅱ法检测各组高危型人乳头瘤病毒的感染情况及病毒负荷载量,分析ACTN4表达与HR-HPV感染、病毒负荷载量的相关性。结果 1.HC-ⅡHPV DNA检测法结果显示:150例标本中HR-HPV阳性98例,阴性52例,阳性低负荷量49例,阳性中负荷量36例,阳性高负荷量13例,并且从正常组、CINⅠ组、CINⅡ组、CINⅢ组到宫颈鳞癌患者组,随着宫颈病变加重,HR-HPV感染率逐渐增加(P=0.000)。2.免疫组化法结果显示:ACTN4在正常组、CINⅠ组、CINⅡ组、CINⅢ组、宫颈鳞癌患者组中阳性表达率分别为0%、33.3%、46.7%、56.7%、73.3%。随着宫颈病变程度的加重,ACTN4蛋白的阳性表达率逐渐上升,差异具有统计学意义(P<0.05)。经过Spearman秩相关分析显示出HR-HPV病毒负荷载量与ACTN4的表达具有相关性(r=0.523,P=0.000)。结论随着宫颈病变程度加重,ACTN4与HR-HPV病毒负荷载量表达率均逐渐升高,且表现出相关性,可作为反映宫颈病变程度及生物学行为的指标,对临床诊断有参考价值。

Objective To investigate the α-actinin 4's( ACTN4) expression in cervical intraepithelial neoplasia and cervical carcinoma, and the correlation with high-risk human papilloma virus( HR-HPV) infection. Methods The 120 pathologic samples were selected from cases of cervical biopsy and resection operation from 2014 June to 2015 February in department of gynaecology,the Second Clinical Hospital of Shanxi Medical University. The patients were CIN Ⅰ, CIN Ⅱ, CIN Ⅲ and early cervical squamous cell carcinoma( Ⅰa-Ⅱa) patients, and 30 samples in each group. In addition, 30 normal patients in colposcopy clinics examination and pathological diagnosis were selected as control group. Using immunohistochemical method to dectect the expression of ACTN4 in cervical carcinoma, and HC-Ⅱ method to detect the high-risk types of human papilloma virus infection and viral load, the author tries to analyze the correlation between ACTN4 ' s expression, HR-HPV infection and viral load. Results 1. HC-ⅡHPV DNA assay results showed that: In 150 cases, 98 cases are HR-HPVpositive specimens, 52 cases are negative, in which 49 are low positive load, 36 are medium positive load, 13 are high load positive. With cervical lesions aggravation, HR-HPV infection gradually increased( P = 0. 000) from the normal group, CIN Ⅰ group, CIN Ⅱ group, CIN Ⅲ group to the cervical squamous cell carcinoma patients. 2. Immunohistochemistry showed: Positive expression rates of ACTN4 in normal group, CINⅠ group, CINⅡ group, CIN Ⅲ group and cervical squamous cell were 0%,33. 3%,46. 7%,56. 7%,73. 3%. As the severity of cervical lesions, ACTN4 protein expression rate gradually increases, the difference is statistically significant( P < 0. 05). After Wilcoxon correlation analysis, it shows that HR-HPV viral load and ACTN4' s expression are correlated( r = 0. 523, P = 0. 000).Conclusions With cervical lesions aggravation, ACTN4 and HR-HPV virus load capacity expression rate are increased, and showed correlation, which can be used as indicators to reflect the degree of cervical lesions and biological behavior, have reference value for clinical diagnosis.