子宫颈鳞形细胞癌患者HPV-DNA、p16~(INK4A)表达变化及其与疾病严重程度关系研究
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摘要
目的探讨子宫颈鳞形细胞癌患者HPV-DNA、p16~(INK4A)表达变化及其与疾病严重程度的关系,为评估患者疾病的严重程度、提高诊断的准确性提供依据。方法选择患有子宫颈鳞形细胞癌变的患者165例为研究对象,其中CINⅠ30例、CINⅡ30例、CINⅢ30例,宫颈鳞形细胞癌Ⅰ期30例、Ⅱ期25例、Ⅲ～Ⅳ期20例;同时选择30例正常宫颈组织,采用第二代杂交捕获法(HC-2)对HPV-DNA进行检测,免疫组织化学检测p16~(INK4A)蛋白表达含量。结果宫颈癌变组织中CINⅠ、CINⅡ、CINⅢ以及宫颈鳞形细胞癌Ⅰ期、Ⅱ期、Ⅲ～Ⅳ期HPV-DNA的阳性检出率以及p16~(INK4A)蛋白表达阳性率均显著高于正常宫颈组织,差异均有统计学意义(P<0. 05);随着组织的不断恶化,疾病严重程度的加深,HPV-DNA的阳性检出率以及p16~(INK4A)蛋白表达阳性率不断增高;同时根据相关性分析,HPV-DNA的阳性检出率与p16~(INK4A)蛋白表达阳性率成正相关关系(P<0. 05)。结论HPV-DNA以及p16~(INK4A)表达变化有利于子宫颈鳞形细胞癌的诊断以及疾病严重程度的评估,值得临床推广。
Objective To explore the changes of expressions of HPV-DNA and p16~(INK4A) Ain patients with cervical squamous cell carcinoma and the relationships with severity of the disease,provide a basis for evaluating severity of the disease and improving the diagnostic accuracy. Methods A total of 165 patients with cervical squamous cell carcinoma were selected as study object,30 cases of cervical intraepithelial neoplasia (CIN) Ⅰ,30 cases of CIN Ⅱ,30 cases of CIN Ⅲ,30 cases of cervical squamous cell carcinoma stage Ⅰ,25 cases of cervical squamous cell carcinoma stage Ⅱ,and 20 cases of cervical squamous cell carcinoma stage Ⅲ-Ⅳ were included,30 cases of normal cervical tissue were selected at the same time,HPV-DNA was detected by HC-2,immunohistochemistry was used to detect p16~(INK4A) Aprotein expression content. Results The positive detection rates of HPV-DNA and the positive expression rates of p16~(INK4A) Aprotein in patients with CIN and cervical squamous cell carcinoma were statistically significantly higher than those in patients with normal cervical tissue (P<0. 05).With aggravation of cervical tissue,the severity of the disease increased,the positive detection rate of HPV-DNA and the positive expression rate of p16~(INK4A) Aprotein increased. Correlation analysis showed that the positive detection rate of HPV-DNA was positively correlated with the positive expression rate of p16~(INK4A) Aprotein (P<0. 05). Conclusion The changes of HPV-DNA and p16~(INK4A) Aprotein expression are beneficial to diagnosis of cervical squamous cell carcinoma and assessment of the severity of the disease,which is worthy of clinical promotion.
Objective To explore the changes of expressions of HPV-DNA and p16~(INK4A) Ain patients with cervical squamous cell carcinoma and the relationships with severity of the disease,provide a basis for evaluating severity of the disease and improving the diagnostic accuracy. Methods A total of 165 patients with cervical squamous cell carcinoma were selected as study object,30 cases of cervical intraepithelial neoplasia (CIN) Ⅰ,30 cases of CIN Ⅱ,30 cases of CIN Ⅲ,30 cases of cervical squamous cell carcinoma stage Ⅰ,25 cases of cervical squamous cell carcinoma stage Ⅱ,and 20 cases of cervical squamous cell carcinoma stage Ⅲ-Ⅳ were included,30 cases of normal cervical tissue were selected at the same time,HPV-DNA was detected by HC-2,immunohistochemistry was used to detect p16~(INK4A) Aprotein expression content. Results The positive detection rates of HPV-DNA and the positive expression rates of p16~(INK4A) Aprotein in patients with CIN and cervical squamous cell carcinoma were statistically significantly higher than those in patients with normal cervical tissue (P<0. 05).With aggravation of cervical tissue,the severity of the disease increased,the positive detection rate of HPV-DNA and the positive expression rate of p16~(INK4A) Aprotein increased. Correlation analysis showed that the positive detection rate of HPV-DNA was positively correlated with the positive expression rate of p16~(INK4A) Aprotein (P<0. 05). Conclusion The changes of HPV-DNA and p16~(INK4A) Aprotein expression are beneficial to diagnosis of cervical squamous cell carcinoma and assessment of the severity of the disease,which is worthy of clinical promotion.
引文
[1]李玉霞,宋晓婕,陈莉,等.宫颈癌筛查中高危型HPV及液基细胞学联合应用的临床价值[J].中国妇幼保健,2015,30(3):479-481.
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[7]何晓明,尤志学,朱岩,等.阴道镜直视下宫颈活检诊断CINII中漏诊CINII以上病变的研究及意义[J].现代妇产科进展,2016,25(7):481-486.
[8]朱方培,任青玲.宫颈癌及癌前病变早期筛查的新进展[J].现代肿瘤医学,2016,28(1):149-152.
[9]Elisei R,Shiohara M,Koeffler HP,et al.Genetic and epigenetic alterations of the cyclin-dependent kinase inhibitors p15INK4b and p16INK4a in human thyroid carcinoma cell lines and primary thyroid carcinomas[J].Cancer,2015,83(10):2185-2193.
[10]蔡斌,吴昊,丰有吉,等.100例宫颈癌临床病理特征与宫旁侵犯和盆腔淋巴结转移的关系分析[J].实用妇产科杂志,2015,31(5):366-368.
[11]张婵,孙媛,吴茉莉,等.HPV病毒感染与宫颈炎症及宫颈癌之间的关系及意义分析[J].中国微生态学杂志,2015,27(8):968-970.
[12]刘婷艳,毛玲芝,孙小丽,等.不同HPV基因亚型单纯性感染与宫颈病变的关系[J].中国生育健康杂志,2015,26(3):211-215.
[13]程晓东,谢幸.重视宫颈癌手术治疗个体化提高患者生存质量[J].中国实用妇科与产科杂志,2015,31(6):490-492.
[14]臧元怡.高危HPV检测联合TCT在宫颈癌筛查中的应用[J].现代中西医结合杂志,2015,24(11):1184-1186.
[15]张涛,毛世华,唐良萏.宫颈上皮内瘤变及早期宫颈癌组织中P16、HPV L-1壳蛋白的表达及与HR-HPV载量相关性研究[J].实用妇产科杂志,2016,32(7):536-539.
[2]郁明霞,徐军,席晓薇.P16ink4a、Ki67蛋白联合检测在HPV持续感染的宫颈病变早期诊断中的临床意义[J].临床和实验医学杂志,2017,16(10):185-187.
[3]宋保志,刘佳华,高玉玲,等.P16INK4A在宫颈上皮内瘤变中的表达及与HPV感染的关系[J].实用癌症杂志,2016,31(5):730-733.
[4]黄静.p16INK4A蛋白及HPV感染与宫颈病变相关性及预后分析[J].中国妇幼保健,2015,30(19):3130-3132.
[5]Dalianis T,Grün N,Koch J,et al.Human papillomavirus DNA and p16(INK4a)expression in hypopharyngeal cancer and in relation to clinical outcome,in Stockholm,Sweden[J].Oral Oncol,2015,51(9):857-861.
[6]王静芳,郝敏,赖炜玲.P16~(INK4A)在宫颈液基细胞学涂片中的表达及意义[J].中国药物与临床,2015,18(5):618-620.
[7]何晓明,尤志学,朱岩,等.阴道镜直视下宫颈活检诊断CINII中漏诊CINII以上病变的研究及意义[J].现代妇产科进展,2016,25(7):481-486.
[8]朱方培,任青玲.宫颈癌及癌前病变早期筛查的新进展[J].现代肿瘤医学,2016,28(1):149-152.
[9]Elisei R,Shiohara M,Koeffler HP,et al.Genetic and epigenetic alterations of the cyclin-dependent kinase inhibitors p15INK4b and p16INK4a in human thyroid carcinoma cell lines and primary thyroid carcinomas[J].Cancer,2015,83(10):2185-2193.
[10]蔡斌,吴昊,丰有吉,等.100例宫颈癌临床病理特征与宫旁侵犯和盆腔淋巴结转移的关系分析[J].实用妇产科杂志,2015,31(5):366-368.
[11]张婵,孙媛,吴茉莉,等.HPV病毒感染与宫颈炎症及宫颈癌之间的关系及意义分析[J].中国微生态学杂志,2015,27(8):968-970.
[12]刘婷艳,毛玲芝,孙小丽,等.不同HPV基因亚型单纯性感染与宫颈病变的关系[J].中国生育健康杂志,2015,26(3):211-215.
[13]程晓东,谢幸.重视宫颈癌手术治疗个体化提高患者生存质量[J].中国实用妇科与产科杂志,2015,31(6):490-492.
[14]臧元怡.高危HPV检测联合TCT在宫颈癌筛查中的应用[J].现代中西医结合杂志,2015,24(11):1184-1186.
[15]张涛,毛世华,唐良萏.宫颈上皮内瘤变及早期宫颈癌组织中P16、HPV L-1壳蛋白的表达及与HR-HPV载量相关性研究[J].实用妇产科杂志,2016,32(7):536-539.
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