摘要
目的观察HPV高危型阳性的高级别鳞状上皮内瘤变(High-Grade squamous intraepithelial lesion,HSIL)、慢性炎症以及p16在不同分型宫颈癌病灶中的表达。方法对2017年3月~2019年3月期间接收治疗的HPV高危型阳性的HSIL、HPV高危型阳性慢性宫颈炎、HPV阴性慢性宫颈炎及宫颈癌患者中随机选取200例作为研究对象。根据疾病类型,HPV高危型阳性的HSIL患者110例,设为HSIL组;HPV高危型阳性慢性宫颈炎患者27例,设为HPV阳性组;HPV高危型阴性慢性宫颈炎患者27例,设为HPV阴性组;宫颈癌疾病患者36例,设为宫颈癌组。所有入组患者均接受病理组织学检验,检测HPV分型以及p16蛋白表达情况。结果所有高危HPV患者病理组织样本中占比由高到低的4类分型依次为HPV16、HPV52、HPV58和HPV31,χ2检验结果显示研究中所有HPV分型检测具有高度一致性,差异无统计学意义(P>0.05);比较各组患者病理组织样本中检验p16蛋白表达阳性率,由高到低依次为宫颈癌组、HSIL组、HPV阳性组和HPV阴性组,各组间差异有统计学意义(P<0.05);经回归分析,13种不同高危HPV的p16蛋白表达水平与HPV高危分型存在明显正相关性(P均<0.05)。结论p16蛋白阳性表达率与HPV高危分型具有明显相关性,随患者宫颈疾病病变程度的加重而增加;宫颈癌患者病理组织p16蛋白阳性表达率最高,HPV高危型阴性慢性宫颈炎患者病理组织p16蛋白阳性表达率最低,临床对HPV分型与p16蛋白表达进行联合检测可反映不同宫颈疾病的发生和进展,具有重要诊断价值。
Objective To depict the expression of p16 in high grade squamous intraepithelial lesion(HSIL),cervicitis and cervical cancer lesion and to discuss it′s correlation with high-risk HPV types.Methods A perspective study was conducted among 200 patients randomly selected from a pool of patients with high-risk HPV positive HSIL,high-risk HPV positive chronic cervicitis,HPV negative chronic cervicitis and cervical cancer treated in our hospital from March 2017 to March 2019.According to the disease type,they were assigned into HSIL group(110 cases with high-risk HPV positive HSIL),HPV positive group(27 cases with high-risk HPV positive chronic cervicitis).HPV negative group(27 cases with high-risk HPV negative chronic cervicitis)and cervical cancer group(36 cases with cervical cancer).Histopathological examination was performed to determine HPV type and p16 protein level.Results HPV16 was the most common HPV type among all cases with positive high-risk HPV,followed by HPV52,HPV58 and HPV31.Chi-square test showed that all HPV types detected in the study were highly consistent,with no statistical significant difference(P>0.05).The positive rate of p16 protein in the pathological tissue samples of patients was the highest of 100%in cervical cancer group,followed by 83.64%in HSIL group,59.26%in HPV positive group and11.11%in HPV negative group,the differences were statistically significant(P<0.05).Regression analysis showed that p16 protein expression levels of 13 high-risk HPV types were positively correlated with high-risk HPV types(all P<0.05).Conclusions The positive rate of p16 protein is closely correlated with high-risk HPV types,which increases along with the severity of cervical diseases,and was the highest in cervical cancer,while the lowest in high-risk HPV negative chronic cervicitis.Paralleled detection of HPV type and p16 protein can reflect the occurrence and progress of different cervical diseases,which has important diagnostic value.
作者
赵健
林军
林静
ZHAO Jian;LIN Jun;LIN Jing(Pathology department,Quzhou People′s Hospital,Quzhou,Zhejiang,324000,China)
出处
《中国预防医学杂志》
CAS
CSCD
2020年第6期666-670,共5页
Chinese Preventive Medicine
基金
浙江省卫生厅科研基金资助项目(Y16H090120)
关键词
HPV高危型
高级别鳞状上皮内瘤变
宫颈慢性炎症
宫颈癌
P16
HPV分型
相关性
HPV high-risk type
High-grade squamous intraepithelial neoplasia
Chronic cervical inflammation
Cervical cancer
p16
HPV types
The correlation
