宫颈癌前病变中人乳头状瘤病毒16/18DNA整合状态的研究  

Detection of physical status of HPV16/18 in cancer precursor lesions

作　　者：张鋆歆[1] 陈妹琼[1] 彭凌[1] 李东爽 袁士成[1] 

机构地区：[1]解放军305医院病理科,北京100017

出　　处：《诊断病理学杂志》2010年第2期143-147,共5页Chinese Journal of Diagnostic Pathology

基　　金：军队十一五课题面上项目(06MA363)

摘　　要：目的探讨宫颈癌及癌前病变中人乳头状瘤病毒(HPV)16/18DNA整合入宿主基因组的发生情况。方法选取128例HPV16/18阳性患者的液基细胞学剩余标本,其中炎症18例,CINⅠ35例,CINⅡ29例,CINⅢ24例,SCC22例。采用荧光定量PCR检测HPV16/18的E2和E6基因,根据E2/E6比值判定HPV16/18DNA的存在状态。结果①确定0.8和0.83分别为荧光定量PCR区分游离型和混合型HPV16/18的界值。②HPV16/18整合发生率与不同程度的宫颈病变有关,并且随着宫颈病变级别的升高,整合发生率呈上升趋势。③混合型在CINⅡ和CINⅢ中所占比例最高。结论HPV16/18整合是宫颈癌变的早期事件,与宫颈癌前病变的进展有关;荧光定量PCR可以作为细胞学筛查的一种有效方法,以发现向宫颈高度鳞状上皮病变、宫颈癌发展的高危患者。Objective To investigate the prevalence of physical status of HPV16/18 DNA into the host genome in cancer precursor lesions and cervical carcinoma. Methods Real-time PCR was used to detect the HPV16/18 physical status in the surplus cells from liquid-based cytological samples from 128 patients with cancer precursor lesions and cervical carcinoma. The samples included 18 cases of cervicitis, 35 CIN Ⅰ, 29 CIN Ⅱ, 24 CIN Ⅲ and 22 SCC. Real-time PCR was employed to quantify the copy number of E2 and E6 genes and analyze the physical status of HPV 1 6 DNA according to E2/E6. Results The cutoff value of E2/E6, used to distinguish the pure episomal form from a mixed form of episomal and integrated HPV16/18 DNA, was 0. 8 and 0. 83, respectively. The rate of HPV integration was associated with the degree of cervical lesions and the rate increased with the progression of cervical disease, and there was significant difference. The mixed episomal/integrated form of HPV16/18 constituted the majority in most of the CIN lI and CIN m cases. Conclusion The integration of HPV16/18 DNA is a very early event in the development of cervical cancer and may act as an activation mechanism for progression from precancerous lesions to cervical cancer. Real-time PCR would be a helpful tool for cytological screening to identify those patients at high risk of developing high-grade squamous intraepithelial lesions and cervical cancer.

关 键 词：宫颈癌 人乳头状瘤病毒16/18 整合 荧光定量PCR 

分 类 号：R711.74[医药卫生—妇产科学]