摘要
目的了解宫颈癌及癌前病变中高危型人乳头瘤病毒(HPV)负荷量和端粒酶活性表达的作用及临床意义。方法随机选取宫颈病变病人130例,其中宫颈上皮内瘤变(CIN)80例,宫颈癌20例,慢性宫颈炎30例(对照组)。采用第二代杂交捕获技术(HCⅡ)检测病人宫颈脱落细胞HPV-DNA含量,阴道镜下定位活检,并用免疫组织化学EnVision二步法检测宫颈组织标本中端粒酶活性的表达。结果随着宫颈病变程度的加重,高危型HPV的表达阳性率和病毒负荷量均增高,宫颈癌组和CINⅢ组高危型HPV表达阳性率明显高于对照组、CINⅠ及CINⅡ组(χ2=7.414～29.501,P<0.01);CINⅡ、CINⅢ及宫颈癌组高危型HPV的病毒负荷量均高于CINⅠ组,差异均有显著性(χ2=2 045.871,P<0.05)。宫颈癌组端粒酶活性表达阳性率高于CINⅢ组,CINⅢ组高于CINⅡ组,CINⅡ组高于CINⅠ组,差异均有显著性(χ2=4.022～4.329,P<0.05)。对照组、CINⅠ、CINⅡ、CINⅢ及宫颈癌组的高危型HPV感染病人中端粒酶活性表达的阳性率分别为0(0/5)、25.00%(2/8)、37.50%(6/16)、72.22%(13/18)、100.00%(19/19)。结论高危型HPV负荷量和端粒酶活性均与宫颈癌前病变及宫颈癌的发生发展密切相关,两者联合检测有望成为宫颈癌早期筛查、处理及预后判断的辅助指标。
Objective To study the role and clinical significance of high risk human papillomavirus （HR-HPV） load and telomerase activation in cervical cancer and premalignant cervical lesions. Methods This study consisted of 130 patients with cervical lesions, of whom, 80 with cervical intraepithelial neoplasia （CIN）, 20 with cervical cancer and 30 with chronic cervicitis （control group）. HPV DNA in cervical exfoliated cells was detected by second-generation hybrid capture technology, a colposcopic locating biopsy was done, the expression of telomerase in cervical tissue was detected by immunohistochemistry. Results With the deterioration of cervical lesions, HR-HPV load and positive rate of HPV infection increased gradually. The positive rate of HPV infection was significantly higher in the cancer than that in the control, CIN I and CIN 11 group （x^2= 7. 414-29. 501, P〈0. 01）. The HR-HPV load in CJN 11 , CINIII and cervical cancer was higher than that in CIN I , the difference was significant a- mong them （x^2=2 045. 871 ,P〈0.05）. The positive rate of telomerase in cervical cancer was higher than that in CIN Ⅲ, that in CIN IU was higher than that in CIN Ⅲ, and CIN Ⅱ was higher than CIN I （x^2=4. 022-4. 329, P〈0.05）. The positive rates of te- lomerase in control group, CIN I group, CIN I/ group, CIN IH group and cancer group with HR-HPV infection were 0 （0/5）, 25.00%（2/8）, 37.50% （6/16）, 72.22%（13/18） and 100.00%（19/19）, respectively. Conclusion HR-HPV infection and te- lomerase activation are closely associated with the occurrence and development of premalignant cervical lesions and cervical cancer, combined detection of these two parameters are hopeful that they will become an aid index for early screen, management and prog- nostic prediction of cervical cancer.
出处
《齐鲁医学杂志》
2012年第5期407-409,412,共4页
Medical Journal of Qilu
