宫颈病变患者病变组织HPV整合状态的变化及意义

目的检测宫颈病变患者病变组织中HPV-16、18整合状态，并探讨HPV DNA整合状态与宫颈癌演变的关系。方法采用多重PCR技术扩增HPV16、18 E2全长基因和E6基因，对扩增产物电泳后条带面积灰度值进行半定量分析，判定HPV的整合状态。结果54例宫颈病变患者宫颈组织中49例患者检出HPV16感染（90．74％）。在49例HPV16阳性组织中，26例慢性宫颈炎患者HPV完全以游离状态存在，8例原位癌组织中3例检测为整合状态（37．5％），7例早期浸润癌5例整合（71．4％），8例中晚期癌全部以整合状态存在（100％）。不同宫颈病变患者宫颈组织HPV整合率相比，P〈0．01。结论随着宫颈病变程度加重，HPV基因组整合率逐渐增高，HPV DNA整合可能是宫颈癌演变的早期标志。对HPV DNA整合状态进行检测，可早期预测宫颈癌细胞病变的性质。

Change and siginificance of HPV integrated state in cervical lesions

Objective To analyze the integration state of human papillomavirus （HPV）16、18 in cervical lesions, and investigate the relation between HPV DNA integration and the development of cervical cancer. Methods Multplex PCR with specific primers for HPV16 and HPV18 E2/E6 genes was used to assess the viral integration state. Scion Image 4.0 electrophoresis image analysis soft was used to calculate the area of electrophoresis product. Results HPV16 infection were found in 49 patients （90.74%）. Episomal states existed in 28 cases chronic cervicitis exclusively. The prevalence of integrated form was 37.5% in the patients of situ careinomalate, 71.4% in micro invasive carcinom, and 100% in the stage of cervical cancer, with significant differences between any 2 groups （ P 〈 0.01 ） o Conclusion HPV DNA integration rate increase with cervical injury. HPV DNA integration may be a key event in cervical carcinogenesis. Detecting the integration state of HPV DNA can predict the character of cervical cytopathics.