HPV16E7基因和P16~(INK4A)蛋白在宫颈病变中的表达及其临床意义

目的:检测宫颈病变组织中HPV16E7基因和P16INK4A蛋白的表达,分析基因表达变化的临床意义。方法:入选慢性宫颈炎和CINⅠ^Ⅱ患者81例、CINⅢ、宫颈浸润性鳞癌患者57例,采用PCR扩增技术检测宫颈病变组织HPV16E7基因表达,采用免疫组化方法检测宫颈病变组织P16INK4A蛋白表达,用SPSS软件行等级相关分析和χ2检验。结果:⑴HPV16E7特异性片段阳性率在慢性宫颈炎、CINⅠⅡ患者81例、CINⅢ、宫颈浸润性鳞癌患者57例,采用PCR扩增技术检测宫颈病变组织HPV16E7基因表达,采用免疫组化方法检测宫颈病变组织P16INK4A蛋白表达,用SPSS软件行等级相关分析和χ2检验。结果:⑴HPV16E7特异性片段阳性率在慢性宫颈炎、CINⅠ^Ⅱ中分别为17.0%、26.5%,在CINⅢ及宫颈浸润性鳞癌中分别为61.5%和74.2%;HPV16E7分布在慢性宫颈炎、CINⅠⅡ中分别为17.0%、26.5%,在CINⅢ及宫颈浸润性鳞癌中分别为61.5%和74.2%;HPV16E7分布在慢性宫颈炎、CINⅠ^Ⅱ和CINⅢ、宫颈浸润性鳞癌间差异具有统计学意义(P<0.001);⑵P16INK4A蛋白的表达在慢性宫颈炎、CINⅠⅡ和CINⅢ、宫颈浸润性鳞癌间差异具有统计学意义(P<0.001);⑵P16INK4A蛋白的表达在慢性宫颈炎、CINⅠ^Ⅱ分别为10.6%和30.0%,在CINⅢ和宫颈浸润性鳞癌中分别为96.0%和100%;P16INK4A蛋白的表达在慢性宫颈炎、CINⅠⅡ分别为10.6%和30.0%,在CINⅢ和宫颈浸润性鳞癌中分别为96.0%和100%;P16INK4A蛋白的表达在慢性宫颈炎、CINⅠ^Ⅱ和CINⅢ、宫颈浸润性鳞癌间差异具有统计学意义(P<0.001);⑶在HPV16E7特异性片段表达阳性的宫颈病变组织中,P16INK4A蛋白的表达均是阳性。宫颈病变组织中P16INK4A蛋白与HPV16E7的表达有相关性(r=0.482,P<0.001)。结论:HPV16E7和P16INK4A蛋白与宫颈上皮内瘤变和宫颈癌的发生具有相关性,HPV16E7和P16INK4A蛋白可能是宫颈上皮内瘤变和宫颈癌的早期预测指标。

Significance and Expression of Human Papiilomavirus Type 16 E7 Gene and P16INK4A Protein in Patients with Cervical Lesion

Objective To investigate the expression of human papillomavirus type 16 E7 （HPV16E7） gene and P16INK4A protein in cervical lesion, and to analyze its clinical significance. Mothods Eighty-one patients with chronic eervicitis or cervical intraepithelial neoplasia（CIN） grade I to II ,57 patients with CIN grade III or cervical squamous-cell carcinoma（SCC） were enrolled. The expression of HPV16E7 gene and P16INK4A protein in cervical lesion was determined with PCR and immunohisto-chemisty staining. The rank correlation and ehi-square test were performed with SPSS software. Results （1）The positive rate of HPV16E7 was 17.0% and 26.5% in patients with chronic cervicitis and CIN grade I to II ,but it was up to 61.5% and 74.2% in patients with CIN grade III and SCC,respectively. The positive rate of HPV16E7 had obvious difference between patients with chronic eervieitis or CIN grade I to II group and patients with CIN grade III or SCC group（P 〈0.01 ）. （2）The positive rate of P16INK4A was 10.6% and 30.0% in patients with chronic cervicitis and CIN grade I to II ,but it was up to 96.0% and 100% in patients with CIN grade III and SCC,respectively. The positive rate of P16INK4A had obvious difference between patients with chronic cervicitis or CIN grade I to II group and patients with CIN grade III or SCC group （P 〈 0. 01 ）. （3）The P16INK4A protein was positively expressed in cervical lesion with positive HPV16E7 expression. The expression of P16INK4^ protein was correlated with the expression of HPV16E7 （ r = 0. 482, P 〈 0. 01 ）. Conclusion HPV16E7 and P16INK4A may involve in the pathogenesis of cervical intraepithelial neoplasia and cervical cancer, and could be the predictive indexes of early CIN and CSS.