HR-HPV载量和HR-HPV E6或E7 mRNA在宫颈癌和癌前病变的表达和意义

Expression and Significance of HR-HPV Load and HR-HPV E6 or E7 mRNA in Cervical Cancer and Precancerous Lesions

目的观察高危型人乳头瘤病毒(HR-HPV)载量和HR-HPV E6与E7 mRNA在宫颈癌和癌前病变的表达情况和意义。方法选取2020年5月-2021年5月在我院诊治的89例HPV持续感染患者为研究对象,依据病理组织分为宫颈癌组(n=33)、宫颈上皮内瘤变(CIN)Ⅰ组(n=19)、CINⅡ组(n=17)、CINⅢ组(n=20),分别行HR-HPV载量、HR-HPV E6或E7 mRNA检测,比较各组HR-HPV DNA载量、HR-HPV E6或E7 mRNA检出阳性率和表达水平,分析不同HR-HPV载量各类型宫颈病变的发生率以及不同宫颈病变与HR-HPV载量、HR-HPV E6或E7 mRNA的相关性。结果各组HR-HPV DNA阳性率均大于阴性率,宫颈癌组、CINⅡ组、CINⅢ组HR-HPV E6或E7 mRNA阳性率均大于阴性率,CINⅠ组阳性率小于阴性率,差异有统计学意义(P<0.05);CINⅡ组HR-HPV DNA载量阳性率与HR-HPV E6或E7 mRNA比较,差异无统计学意义(P>0.05);宫颈癌组、CINⅢ组HR-HPV DNA阳性率、HR-HPV E6或E7 mRNA阳性率均大于CINⅠ组、CINⅡ组,差异有统计学意义(P<0.05),宫颈癌组与CINⅢ组比较,差异无统计学意义(P>0.05),但CINⅡ组大于CINⅠ组,差异有统计学意义(P<0.05);宫颈癌组、CINⅡ组、CINⅢ组HR-HPV DNA载量、HR-HPV E6或E7 mRNA水平均高于CINⅠ组,差异有统计学意义(P<0.05),宫颈癌组与CINⅢ组比较,差异无统计学意义(P>0.05);CINⅠ组HR-HPV DNA载量水平与CINⅡ比较,差异无统计学意义(P>0.05),CINⅡ组HR-HPV E6或E7 mRNA水平高于CINⅠ组,差异有统计学意义(P<0.05);不同HR-HPV载量组,CINⅠ、CINⅡ、CINⅢ和宫颈癌的发生率比较,差异有统计学意义(P<0.05);HPV E6或E7 mRNA和HR-HPV DNA间存在相关性,CINⅠ、CINⅡ与其呈正相关(P<0.05),CINⅢ与宫颈癌无相关性(P>0.05)。结论在宫颈上皮内瘤变CINⅠ阶段,HR-HPV和HR-HPV E6或E7 mRNA均开始表达,且随表达量升高,病理分级升高,进一步加速宫颈癌的发生。同时两者存在相关性,揭示了HPV载量与病变严重程度的一致性。

Objective To observe the expression and significance of the high risk human papillomavirus(HR-HPV)load and the expression of HR-HPV E6 and E7 mRNA in cervical cancer and precancerous lesions.Methods A total of 89 patients with persistent HPV infection diagnosed and treated in our hospital from May 2020 to May 2021 were selected and divided into cervical cancer group(n=33),cervical intraepithelial neoplasia(CIN)Ⅰgroup(n=19),CINⅡgroup(n=17),and CINⅢgroup(n=20)according to the pathological tissue.HR-HPV load,HR-HPV E6 or E7 mRNA were detected respectively,and the positive rates and expression levels of HR-HPV DNA load,HR-HPV E6 or E7 mRNA in each group were compared.The incidence of various types of cervical lesions with different HR-HPV loads and the correlation between different cervical lesions and HR-HPV loads,HR-HPV E6 or E7 mRNA were analyzed.Results The positive rate of HR-HPV DNA in each group was higher than the negative rate,the positive rate of HR-HPV E6 or E7 mRNA in cervical cancer group,CINⅡgroup and CINⅢgroup was higher than the negative rate,the difference was statistically significant(P<0.05).There was no significant difference in the positive rate of HR-HPV DNA load between CINⅡgroup and HR-HPV E6 or E7 mRNA(P>0.05);the positive rates of HR-HPV DNA and HR-HPV E6 or E7 mRNA in cervical cancer group and CINⅢgroup were higher than those in CINⅠgroup and CINⅡgroup,and the difference was statistically significant(P<0.05),there was no significant difference between cervical cancer group and CINⅢgroup(P>0.05),but the CINⅡgroup was greater than CINⅠgroup,and the difference was statistically significant(P<0.05).The HR-HPV DNA load,HR-HPV E6 or E7 mRNA levels in cervical cancer group,CINⅡgroup and CINⅢgroup were higher than those in CINⅠgroup,and the differences were statistically significant(P<0.05);there was no significant difference between cervical cancer group and CINⅢgroup(P>0.05);there was no significant difference in HR-HPV DNA load between CINⅠgroup and CINⅡgroup(P>0.05);the mRNA levels of HR-HPV E6 or E7 in CINⅡgroup were higher than those in CINⅠgroup,and the difference was statistically significant(P<0.05).There was significant difference in the incidence of CINⅠ,CINⅡ,CINⅢand cervical cancer among different HR-HPV loading groups(P<0.05).There was a correlation between HPV E6 or E7 mRNA and HR-HPV DNA,and CINⅠand CINⅡwere positively correlated(P<0.05),there was no correlation between CINⅢand cervical cancer(P>0.05).Conclusion In the CINⅠstage of cervical intraepithelial neoplasia,HR-HPV and HR-HPV E6 or E7 mRNA begin to be expressed,and and with the increase of expression and pathological grade,the occurrence of cervical cancer is further accelerated.At the same time,there is a correlation between the HR-HPV and HR-HPV E6 or E7 mRNA,revealing the consistency between HPV load and the severity of lesions.