P16蛋白、HPV L-1壳蛋白在CIN和早期宫颈癌组织中的表达及其筛查价值

目的 分析P16蛋白、人乳头瘤病毒(HPV)L-1壳蛋白在宫颈上皮内瘤变(CIN)和宫颈癌中的表达及筛查价值.方法 选取2014年1月至2016年6月淮安市妇幼保健院妇产科CIN和早期宫颈癌共50例患者,通过第二代杂交捕获法与免疫组化法分析P16蛋白、HPV L-1壳蛋白在其组织中的表达.结果 P16蛋白在慢性宫颈炎(9.09%)、低度鳞状上皮内病变(52.94%)、高度鳞状上皮内病变(84.21%)及早期宫颈癌(100.00%)中的阳性表达率逐渐升高(χ2=45.38,P=0.00),人乳头瘤病毒 L-1壳蛋白阳性表达率亦存在明显差异,分别是18.18%、35.29%、15.79%及0(χ2=12.59,P=0.00);随着病毒载量提高,P16蛋白与人乳头瘤病毒L-1壳蛋白阳性表达率均有所改变(χ2值分别为41.37、32.95,均P<0.01).在慢性宫颈炎中,P16蛋白表达阳性率与高危型人乳头瘤病毒呈正相关关系(r=0.52,P=0.01);在低度鳞状上皮内病变中,P16蛋白、人乳头瘤病毒L-1壳蛋白阳性表达率与高危型人乳头瘤病毒均呈正相关关系(r值分别为0.58、0.33,均P<0.05);在高度鳞状上皮内病变及早期宫颈癌中,P16蛋白、人乳头瘤病毒L-1壳蛋白阳性表达率与高危型人乳头瘤病毒均未存在显著相关性(r值分别为0.12、0.26、0.62,均P>0.05).结论 P16蛋白、人乳头瘤病毒L-1壳蛋白表达阳性可作为宫颈癌前病变出现的分子事件,在筛查CIN和早期宫颈癌中的价值较高,临床上值得应用和推广.

Expressions of P16 and HPV L-1 capsid protein in CIN and early cervical carcinoma and their screening value for cervical precancerous lesions

Objective To analyze the expression and screening value of P16 protein and human papillomavirus L-1 capsid protein in cervical intraepithelial neoplasia (CIN) and cervical carcinoma.Methods Totally 50 patients with CIN and early cervical carcinoma were selected in department of obstetrics and gynecology from Maternal and Child Health-Care Center in Huaian City, and the expressions of P16 and HPV L-1 protein were detected by using hybrid captureⅡand immunohistochemical staining methods.Results The positive rate of P16 in chronic cervicitis (9.09%), low-grade squamous intraepithelial lesion (LSIL) (52.94%), high-grade squamous intraepithelial lesion (HSIL) (84.21%) and early cervical carcinoma (100.00%) were gradually increased (χ2=45.38,P=0.00), and the positive rate of human papillomavirus L-1 capsid protein was 18.18%, 35.29%, 15.79% and 0.00%, respectively, which also had significant differences (χ2=12.59,P=0.00).With the virus load increasing, the positive rates of P16 and human papillomavirus L-1 protein showed significant differences (χ2 value was 41.37 and 32.95, respectively, both P<0.01).In the cases of chronic cervicitis, the positive rate of P16 was positively correlated with the high-risk human papillomavirus (HR-HPV) (r=0.52, P=0.01).In the cases of LSIL, the positive rates of P16 and human papillomavirus L-1 protein were positively correlated with HR-HPV (r value was 0.58 and 0.33, respectively, both P<0.05).In the cases of HSIL and early cervical carcinoma, the positive rates of P16 and human papillomavirus L-1 protein had no significant correlation with high-risk human papillomavirus (r value was 0.12, 0.26 and 0.62, respectively, all P>0.05).Conclusion The positive expressions of P16 and human papillomavirus L-1 caspid protein are molecular events of cervical precancerous lesions, which has high value in the screening of CIN and early cervical carcinoma, so it is worthy of clinical application and promotion.