宫颈脱落细胞中HPV L1壳蛋白的表达及临床意义  

The expression and clinical significance of HPV L1 caspid protein in cytologic specimens of the cervix

作　　者：钱敏[1] 姚芳芳[1] 尤志学[2] 

机构地区：[1]南京医科大学第一临床医学院,210029 [2]南京医科大学第一附属医院妇科

出　　处：《中国妇产科临床杂志》2013年第1期30-33,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨HPV L1壳蛋白在宫颈脱落细胞中的表达及临床意义。方法对2010年1月至2011年10月在南京医科大学第一附属医院就诊的患者的宫颈脱落细胞标本409例用免疫细胞化学法检测HPV L1壳蛋白的表达。结果 HPV L1壳蛋白在NILM、ASCUS、ASC-H、LSIL、HSIL和AGC中的阳性表达率分别为20.54%、49.24%、18.18%、43.90%、18.18%、0%,ASCUS/LSIL组和ASC-H/HSIL组之间差异有统计学意义(P<0.05);HPVL1壳蛋白在慢性宫颈炎、CIN1、CIN2、CIN3、SCC和宫颈腺癌中的阳性表达率分别为36.11%、42.19%、30.23%、26.09%、0%、0%,CIN1组、CIN2/3组、SCC组之间差异有统计学意义(P<0.05);HPVL1壳蛋白在HR-HPV DNA负荷量0～9.9、10～99.9、100～999.9、1000～pg/ml中的阳性表达率分别为6.67%、17.24%、36.72%、51.77%,除0～9.9与10～99.9pg/ml组比较,其余各组间差异均有统计学意义(P<0.05);HPV L1壳蛋白阴性表达对高级别CIN(≥CIN2)预测的灵敏度、特异度、阳性预测值、阴性预测值分别为75.62%、37.98%、54.09%、61.72%。结论 HPV L1壳蛋白在宫颈脱落细胞中的表达率随宫颈病变程度的加重呈下降趋势,随病毒负荷量的增加呈升高趋势。Objective To explore the expression and clinical significance of HPV L1 caspid protein in cytologic specimens of the cervix.Methods The HPV L1 protein in cytologic specimens of the cervix was detected by using immunocytochemical method in 409 women.Results The positive expression rates of HPV L1 caspid protein were 20.54%, 49.24%, 18.18%, 43.90%, 18.18% and 0% in the NILM, ASCUS, ASC-H, LSIL, HSIL and AGC group, respectively. There was significant difference between ASCUS/LSIL and ASC-H/HSIL group（P 0.05）. The positive expression rates of HPV L1 caspid protein were 36.11%, 42.19%, 30.23%, 26.09%, 0% and 0% in the chronic cervititis, CIN1, CIN2, CIN3, SCC and cervical adenocarcinoma group, respectively. The differences among CIN1, CIN2/3 and SCC were significant （P0.05）. The positive expression rates of HPV L1 caspid protein in the HR-HPV DNA loading dose 0~9.9, 10~99.9, 100~999.9 and 1 000~pg/ml were 6.67%, 17.24%, 36.72% and 51.77%, respectively. There were significant differences among all the groups （all P0.05, except between 0~9.9 and 10~99.9 pg/ml）. The sensitivity, specificity, positive predictive value and negative predictive value of HPV L1 caspid protein for detecting high grade cervical lesions were 75.62%, 37.98%, 54.09% and 61.72%, respectively.Conclusions The positive rate of HPV L1 caspid protein in cytologic specimens of the cervix is decreased with the cervical lesion progression and increased with the increase in viral load.

关 键 词：宫颈上皮内瘤变 宫颈癌 人乳头瘤病毒 L1壳蛋白 

分 类 号：R737.33[医药卫生—肿瘤]