宫颈癌发生发展过程中组织微小 RNA-21表达及高危型 HPV 病毒载量变化的意义

目的：研究宫颈癌发生发展过程中组织微小RNA-21表达及高危型HPV病毒载量变化的意义。方法选取2011年3月至2015年3月收治的宫颈病变并行宫颈活检的患者150例， CINⅠ组（ n ＝39）、CINⅡ组（ n ＝37）、CINⅢ组（ n ＝34），CC组（ n ＝40），分析miR-21的表达及HR-HPV载量与宫颈癌临床病理特征的联系，miR-21的表达与HR-HPV载量的相关性，不同宫颈病变中miR-21的表达及HR-HPV载量。结果宫颈癌患者肿瘤细胞低分化者miR-21表达（6．12±0．83）低于中分化者（8．17±0．65）及高分化者（11．54±1．29）（ P ＜0．05）；肿瘤细胞直径＞4 cm者HR-HPV载量（26．53±3．12）高于＜4 cm者（23．60±2．85）（ P ＜0．05），FIGO分期Ⅰ～ⅡA者HR-HPV载量（23．86±2．34）低于ⅡB～Ⅳ者（27．59±3．12）；宫颈癌HR-HPV阳性者miR-21表达（9．75±0．83）高于HR-HPV阴性者（5．47±0．46），差异有统计学意义（ P ＜0．05）；但miR-21表达及HR-HPV载量与宫颈癌年龄、FIGO分期、病理类型、淋巴转移、脉管浸润无明显相关性（ P ＞0．05）；CINⅠ组HR-HPV阳性患者（41．03％）分别低于 CINⅡ组（67．57％）、CINⅢ组（85．29％）及CC组（92．50％），CINⅠ组mi-R21相对表达水平（6．42±0．53）低于CINⅡ组（7．26±0．61）、CINⅢ组（8．24±0．65）及CC组（9．36±0．70），差异有统计学意义（ P ＜0．05）。结论微小RNA-21表达可反应宫颈癌细胞分化程度，高危型HPV病毒载量可反应宫颈癌FIGO分期及肿瘤直径范围，微小RNA-21表达与高危型HPV病毒载量呈正相关，联合检查微小RNA-21及高危型病毒载量能够提示宫颈癌前病变、宫颈癌的发生发展。

Significance of the expression of small RNA-21 and the changes of high-risk HPV viral load in the pathogenesis and development of cervical cancer

Objective To investigate the significance of the expression of small RNA-21 (miR-21) and the changes of high-risk HPV viral load in the pathogenesis and development of cervical cancer.Methods One hundred and fifty patients with cervical lesion who were admitted and treated in our hospital from March 2011 to March 2015 were enrolled in the study, and all the patients underwent cervical biopsy.These patients were divided into CINⅠgroup (n=39),CINⅡ group ( n =37),CINⅢgroup ( n =34), CC group ( n =40).The expression levels of miR-21 and HR-HPV load in different types of cervical lesions were detected.The correlation between the expressins of miR-21 and HR-HPV load was analyzed,moreover, the correlation between the expressins of miR-21 as well as HR-HPV load and clinicopathological charateristics of cervical cancer was analyzed.Results The expression levels of miR-21 in patients with poorly differentiated tumor cells ( 6.12 ± 0.83) were significantly higher than those (8.17 ±0.65) in patients with moderately differentiated tumor cells and those (11.54 ±1.29) in patients with well differentiated tumor cells ( P <0.05).The HR-HPV load (26.53 ±3.12) in patients with tumor diameter >4cm was significantly higher than that (23.60 ±2.85) of patients with tumor diameter <4cm ( P <0.05).The HR-HPV load (23.86 ±2.34) in patients at FIGO staging Ⅰ~ⅡA was obviously lower than that (27.59 ± 3.12) in patients at FIGO stagingⅡB~Ⅳ.The expression levels of miR-21 in HR-HPV-positive patients (9.75 ±0.83) were significantly higher than those (5.47 ±0.46) in HR-HPV-negative patients ( P <0.05).However there were no significant differences in the expression levels of miR-21, HR-HPV load, patient's age, FIGO staging, pathological types, lymphatic metastasis and vessel infiltration ( P >0.05).The percentage (41.03%) of HR-HPV -positive patients (41.03%) in CINⅠgroup (41.03%) was significantly lower that that in CINⅡ group (67.57%), CIN Ⅲ group (85.29%), CC group (92.50%), moreover, the relative expression levels of mi-R21 in CINⅠgroup (6.42 ±0.53) was significantly lower than that in CINⅡ group (7.26 ±0.61),CIN Ⅲ group (8.24 ±0.65) and CC group (9.36 ±0.70) (P<0.05).Conclusion The expression levels of miR-21 can reflect the differentiation degree of cervical cancer cells,and high-risk HPV viral load can reflect FIGO stages of cervical cancer and diameter range of cancer,moreover,the expression of miR-21 is positively correlated to high risk HPV viral load.The combined detection of miR-21 with high risk viral load can suggest cervical precancerous lesions, the pathogenesis and development of cervical cancer.