宫颈癌前病变和宫颈癌组织中凋亡相关基因survivin的表达及其与人乳头状瘤病毒感染的关系

目的探讨凋亡相关基因survivin在宫颈癌前病变和宫颈癌组织中的表达及其与人乳头状瘤病毒（HPV）感染的相关性.方法选取76例宫颈癌前病变或宫颈癌患者,另取10例正常宫颈组织作为对照.应用免疫组织化学SP法检测各组宫颈组织中凋亡相关基因survivin的表达;设计高危型HPV（HPV16,18,31,33,58等）通用引物,以touch-down PCR法检测各组宫颈组织中高危型HPV的感染率.结果（1）从正常宫颈→癌前病变→宫颈癌,survivin表达逐渐增强（P＜0.05）;（2）survivin表达与宫颈癌组织学分级有关（P＜0.05）,而与年龄、临床分期及组织学分型无关（P＞0.05）;（3）从正常宫颈→癌前病变→宫颈癌,高危型HPV阳性率逐渐升高（P＜0.05）;（4）高危型HPV感染率在不同年龄、临床分期、组织学分级及组织学分型中,均无统计学差异（P＞0.05）;（5）survivin与高危型HPV在宫颈癌组织中的表达呈正相关（P＜0.05）.结论survivin表达及高危型HPV感染可能与宫颈癌的发生、发展密切相关,两者在宫颈癌的发病机制中可能起着协同作用.

Association between expression of survivin and high-risk human papillomavirus infection in cervical cancer and precancerous tissues

OBJECTIVE: To investigate the expression of survivin and its association with high-risk human papillomavirus (HPV) infection in cervical cancer and precancerous tissues. METHODS: In 76 patients with cervical intraepithelial neoplasia (CIN) or cervical carcinoma, the expression of survivin was detected by immunohistochemistry and the infection rates of high-risk HPV including HPV16, 18, 31, 33, 52, and 58 were assayed by touch-down PCR, with 10 cases of normal cervical specimens serving as the control. RESULTS: Survivin expression tended to increase along with the tumor progression (P<0.05), and was associated with the histological grade of invasive carcinoma (P<0.05) but not with the patients' age, clinical stage or histological classification (P>0.05). The positivity rate of high-risk HPV increased only in association with tumor progression (P<0.05) but not with the patients' age, clinical stage or histological classification (P>0.05). Positive correlation between the expression of survivin and high-risk HPV infection was observed in cervical carcinoma. CONCLUSION: Survivin might play an important role in the occurrence and development of cervical carcinoma in coordination with high-risk HPV.