HPV L1壳蛋白表达与宫颈病变严重程度的关系研究

目的研究人类乳头瘤病毒（human papilloma virus，HPV）L1壳蛋白的表达与宫颈病变严重程度的关系。方法选取2013年2月-2013年8月于我院妇科就诊的宫颈病变患者529例，所有患者均行薄层液基细胞学检查和组织病理学检查，同时行宫颈活检并采用免疫组织化学法检测HPV L1壳蛋白的表达并分析其与不同程度宫颈病变的相关性。结果529例宫颈病变患者中，组织病理学检查的总符合率为87．52％（463／529）。宫颈细胞学检查中，HPV L1壳蛋白在529例宫颈病变患者中的阳性表达率为29．11％（154／529），其中在未见上皮内病变或恶性病变、未明确意义的不典型鳞状上皮细胞、低度鳞状上皮内病变、高度鳞状上皮内病变、鳞状上皮癌中的表达率分别为20．16％、36．97％、65．15％、18.39％、0．00％，各组间HPV L1壳蛋白阳性表达率比较，差异有统计学意义（P〈0．05）；在慢性宫颈炎、宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）Ⅰ、CINⅡ、CINⅢ和宫颈癌中，HPV L1壳蛋白的阳性表达率分别为26．16％、60．76％、29.33％、16．54％、0．00％，各组的HPV L1壳蛋白阳性表达率差异有统计学意义（P〈0．05）。HR—HPV DNA结果显示，随着HR—HPV DNA负荷量的增加，HPV L1蛋白的表达水平逐渐升高，除HR—HPV DNA 1．1—9．9pg／mL组与10—100pg／mL组之间差异无统计学意义外，其余各组之间两两比较差异均有统计学意义（P均〈0．05）。结论HPV L1壳蛋白的表达随宫颈病变程度的加重而降低，HPV L1壳蛋白表达的检测对癌前病变的筛查和预防有着重要意义。

Relationship research between HPV L1 protein expression and cervical lesions degree

Objective To research the relationship between expression of HPV L1 protein and severity of cervical lesions. Methods 529 cases patients were collected in our hospital from February 2013 to August 2013. All patients were detected by liquid-based cytology test and histopathology. HPV L1 protein was detected by immunohistochemistry. All data were analyzed statistically. Results In 529 cases patients, the total accordance rate of histopathology was 87.52% （463/529）. In liquid-based cytology test, positive rate of HPV L1 protein in 529 cases patients was 29.11% （154/529）, with in no intraepithelial lesion or malignant lesion, atypical squamous cell of unde-termined significance, low squamous intraepithelial lesion, high squamous intraepithelial lesion and squamous cell carcinoma were 20.16%, 36.97%, 65.15%, 18.39% and 0.00% respectively, and the difference among these groups had statistical significance （P〈 0.05）. In histopathology, positive rates of HPV L1 protein in cervical intraepithelial neoplasia （CIN） Ⅰ , CIN Ⅱ , CIN Ⅲ and cervical cancer were 26.16%, 60.76%, 29.33%, 16.54% and 0.00% respectively, and the difference among these groups had statistical significance （P〈 0.05 ）. HR-HPV DNA detection showed that with HR-HPV DNA capacity increased, level of HPV L1 protein was increasing. There were statistical significance among these groups except between 1.1-9.9 pg/mL and 10-100 pg/mL（Pall〈 0.05）. Conclusion Expression of HPV L1 protein decrease with increasing degree of cervical lesions. It has important significance in screening and prevention of precancerous lesions of the expression of HPV L1 protein.