HPV L1壳蛋白在宫颈病变中的表达及与HR-HPV DNA的关系

目的研究人乳头瘤病毒(HPV)L1壳蛋白在宫颈病变中的表达及与高危型人乳头瘤病毒(HR-HPV)DNA的关系,为宫颈病变的早期诊断提供预测指标,为HPV疫苗的研制提供理论依据。方法采用免疫细胞化学方法和第二代杂交捕获法(HC-Ⅱ),分别检测272例女性HPV L1壳蛋白的表达和高危型HPV(HR-HPV)病毒载量,组织活检复查宫颈病变情况。结果 HR-HPV DNA感染者中,随着宫颈病变级别(CINⅠ及以上)的升高,HPV L1壳蛋白阳性表达率增高(x~2=35.176,P0.001),HPV L1壳蛋白诊断CINⅡ及以上的灵敏度为89.77%,特异度为45.12%;按年龄分层后,HPV L1壳蛋白表达与宫颈病变的OR均小于1;小于35岁研究对象中,病毒载量与HPV L1壳蛋白阳性表达率之间存在剂量反应关系(x~2=12.915,P0.001)。结论 HPV L1壳蛋白的缺失与宫颈癌及癌前病变的发生、发展密切相关,年轻女性HPV L1壳蛋白的表达与HPVDNA载量存在剂量反应关系。

A Study on the Expression of HPV L1 Capsid Protein in Cervical Lesions and the Relation to HR-HPV DNA

Objective The paper was to study the expression of HPV L1 capsid protein in cervical lesions and the relation to HR-HPV DNA,to provide a new biomarker for early diagnosis of cervical lesions,and to provide evidence for manufacture of HPV vaccine.Methods Immunochemical method and Hybrid Capture Ⅱ were used to detect the expression of HPV L1 capsid protein and HR-HPV DNA virus load in 272 women,respectively.Cervical lesions were detected by biopsies.Statistical analysis was carried out with the SPSS program,version 13.0.One-way AVONA and χ2 test were used for hypothesis test,Mantel trend analysis was used to analyze the dose-effect relationship between HR HPV virus load and the expression of HPV L1 capsid protein,and values of P<0.05 were considered statistically significant.Results The expression of HPV L1 capsid protein decreased with biopsy diagnosis increasing in HR-HPV infected women(χ2=35.176,P<0.001).The sensitivity of HPV L1 capsid protein diagnosing CIN Ⅱ and above in HR-HPV infected women was 89.77%,and the specificity was 45.12%.Stratified analysis showed the value of OR between the expression of HPV L1 capsid protein and cervical lesions was less than 1.Mantel trend analysis showed dose-response relationship between HR-HPV virus load and the expression of HPV L1 capsid protein in women less than 35 years.Conclusion The absence of HPV L1 capsid protein is closely related to the occurrence and development of cervical lesions;there are dose-relationship between HR-HPV virus load and the expression of HPV L1 capsid protein in young women.