人乳头瘤状病毒16/18型蛋白E6及P53蛋白在宫颈癌前病变中的表达及相关性分析

Expression of HPV16 and 18 E6 and P53 proteins in cervical precancerous lesions

目的观察人乳头状瘤病毒16型和18型(HPV16/18)早期蛋白E6及P53蛋白在宫颈癌前病变中的表达及二者的相关关系。方法选择沧州市人民医院2017年1月至2018年8月手术切除的宫颈不典型增生组织蜡块120例,其中轻度(CINⅠ级)组34例,中度(CINⅡ级)组44例,重度(CINⅢ级)组42例。另选择正常宫颈组织蜡块40例作为对照组。免疫组化测定并比较各组间HPV16/18 E6蛋白及P53蛋白的表达情况,并使用Spearman等级相关分析观察HPV16/18 E6蛋白和P53蛋白阳性表达率之间的相关性。结果4组之间HPV16/18 E6蛋白及P53蛋白阳性表达率差异均有统计学意义(均P<0.05)。其中HPV16/18 E6蛋白阳性表达率CINⅢ级组最高(45.24%),对照组最低(2.50%);P53蛋白的阳性表达率对照组最高(72.50%),CINⅢ级组最低(14.29%)。HPV16/18 E6蛋白和P53蛋白阳性表达结果之间呈负相关性。结论HPV16/18 E6蛋白与宫颈癌前病变的发生密切相关,或可作为宫颈癌诊断的指标之一;P53蛋白对抑制宫颈癌的发生具有重要作用。

Objective To observe the expression of early proteins E6 and P53 in human papillomavirus type 16 and 18 and their relationship in cervical precancerous lesions.Methods 120 cases of cervical cancer were randomly selected from January 2017 to January 2018 for clinical study,including 34 cases of CINⅠ,44 cases of CINⅡand 42 cases of CINⅢ.40 patients without lesion were randomly selected as control group.All specimens were examined by gene test to detect type HPV16 and type HPV18 E6 protein and P53 protein.The immunohistochemical staining results of HPV16,HPV18 E6 and P53 in different atypical hyperplasia pathological specimens and normal controls were observed.The correlation between the positive results of HPV16,HPV18 E6 and P53 was observed by Spearman grade correlation analysis.Results HPV infection was different in different cervical precancerous lesions.The positive rates of HPV16 and HPV18 E6 in CINⅠ,CINⅡand CINⅢwere significantly different from those in control group(P<0.05).The positive rates of P53 in different cervical precancerous lesions were significantly different(P<0.05).The highest positive rate was 72.50%in control group,and the lowest positive rate was 14.29%in CINⅢ.Among the patients with HPV16 and HPV18 E6 positive before cancer in different cervical diseases,the control group had the highest positive rate of P53 staining(100.00%)and the lowest positive rate of CINⅢ(21.05%).The correlation between the positive results of HPV16,HPV18 E6 and P53 staining was also found.Conclusions HPV16 and HPV18 E6 proteins are closely related to the occurrence of cervical precancerous lesions,which provides a new direction for the diagnosis of precancerous lesions.The expression of P53 protein is negatively correlated with HPV16 and HPV18 E6,and plays an important role in inhibiting the occurrence of cervical cancer.