cAMP/PKA通路在HPV16/18相关宫颈癌中的表达情况及临床意义

Analysis of Expression and Clinical Significance of cAMP/PKA Pathway in HPV16/18-associated Cervical Cancer

目的探讨cAMP/PKA通路在HPV16/18相关宫颈癌中的表达情况及临床意义。方法选取86例宫颈癌患者作为研究组,取同期患有妇科其他良性病变行宫颈切除手术患者75例作为对照组。将研究组患者术后切除的宫颈病变组织进行收集,同时收集对照组患者术后切取的宫颈组织标本于液氮中保存。对两组研究对象组织标本中cAMP/PKA通路的表达水平进行比较,采用PCR扩增及膜杂交法对cAMP/PKA阳性组与阴性组标本进行HPV检测。对cAMP/PKA阳性组与阴性组进行免疫组化法检测血管内皮生长因子表达水平情况。采用Spearman相关性分析,对cAMP/PKA通路表达与VEGF表达及宫颈癌HPV16/18感染情况进行相关性分析。结果研究组标本中cAMP/PKA通路阳性率明显高于对照组(P<0.05)。cAMP/PKA通路阳性组患者HPV16/18总阳性率为93.59%,阴性组HPV16/18总阳性率为50.00%,cAMP/PKA通路阳性组中HPV16/18阳性率明显高于阴性组(P<0.05)。cAMP/PKA通路阳性组中VEGF表达水平呈阳性表达有70例(89.74%),阳性率为89.74%;在阴性组中呈阳性表达为3例(37.50%),阳性率为37.50%,cAMP/PKA通路阳性组中VEGF阳性率明显高于阴性组(P<0.05)。经Spearman相关性分析可知,cAMP/PKA通路与VEGF表达水平呈正相关性(P<0.05),cAMP/PKA通路表达水平越高,VEGF的表达水平越高。cAMP/PKA通路与宫颈癌HPV16/18感染情况呈正相关性(P<0.05),cAMP/PKA通路表达水平越高,患者感染HPV16/18的概率越大。结论cAMP/PKA通路的表达与VEGF表达水平及患者感染HPV16/18呈正相关性,cAMP/PKA通路的表达水平升高,可以促进VEGF的表达,同时患者感染HPV16/18的风险也升高。

Objective To discuss the expression and clinical significance of cyclic adenosine monophosphate/protein kinase A(cAMP/PKA)pathway in human papillomavirus(HPV)16/18-associated cervical cancer.Methods 86 patients with cervical cancer and 75 women with benign gynaecological disease underwent surgery were enrolled as the study group and the control group,respectively.The cervical cancer tissues in the study group and normal cervical tissues in the control group resected from surgery were collected and stored in liquid nitrogen.The expression levels of cAMP/PKA pathway in tissue samples of the 2 groups were compared.Polymerase chain reaction(PCR)amplification and hybridization were used to detect HPV in cAMP/PKA positive group and negative group.Immunohistochemical method was performed to examinate the expression level of vascular endothelial growth factor(VEGF)in cAMP/PKA positive group and negative group.Spearman correlation analysis was used to discuss the correlation of cAMP/PKA pathway expression with VEGF expression and HPV16/18 infection in cervical cancer patients.Results The positive rate of cAMP/PKA pathway in the study group was significantly higher than that in the control group(P<0.05).The total positive rate of HPV16/18 in patients with positive cAMP/PKA pathway was 93.59%,and that in patients with negative cAMP/PKA pathway was 50.00%,indicating that the positive rate of HPV16/18 in patients with positive cAMP/PKA pathway was significantly higher than that in patients with negative cAMP/PKA pathway(P<0.05).In the cAMP/PKA pathway positive group,the expression level of VEGF was positive in 70 cases(89.74%),with a positive rate of 89.74%.In the cAMP/PKA pathway negative group,3 cases(37.50%)showed positive VEGF expression,with a positive rate of 37.50%.The positive rate of VEGF in the cAMP/PKA pathway positive group was significantly higher than that in the negative group(P<0.05).Spearman correlation analysis showed that the cAMP/PKA pathway expression was positively correlated with VEGF expression(P<0.05)and HPV16/18 infection rate in cervical cancer patients(P<0.05),suggesting that cervical cancer patients with high expression of cAMP/PKA pathway had high expression of VEGF and high rate of HPV16/18 infection(P<0.05).Conclusion The expression level of cAMP/PKA pathway is positively correlated with VEGF expression and HPV16/18 infection,so,the increased expression level of cAMP/PKA pathway can promote the VEGF expression and increase the risk of HPV16/18 infection in cervical cancer patients.