免疫细胞化学检测微小染色体维持蛋白2在宫颈病变诊断中的价值及其与人乳头瘤病毒感染的关系  

Diagnosis Value of Minichromosome Maintenance Protein 2 by Immunocytochemical Test on Cervical Lesions and Its Relationship With Human Papillomavirus Infection

作　　者：郑健[1] 任杰[1] 幺磊 宋静慧[1] 

机构地区：[1]内蒙古医科大学附属医院妇产科,内蒙古自治区呼和浩特010059

出　　处：《中华妇幼临床医学杂志（电子版）》2013年第6期634-639,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：内蒙古卫生厅2010年医疗卫生科研计划项目(2010028)~~

摘　　要：目的探讨微小染色体维持蛋白2(MCM2)在宫颈病变中的表达和临床意义及其与人乳头瘤病毒(HPV)感染的关系。方法选取2011年10月到2012年12月在内蒙古医科大学附属医院妇产科就诊并行宫颈薄层液基细胞学检查(TCT)检查和13种高危型HPV(HR-HPV)分型检测的183例宫颈病变患者为研究对象,并对TCT剩余标本进行MCM2免疫细胞化学染色,并与宫颈组织的病理学检查结果进行比较(本研究遵循的程序符合内蒙古医科大学附属医院人体试验委员会制定的伦理学标准,得到该委员会批准,并征得受试对象的知情同意)。结果 MCM2的阳性表达率和HR-HPV阳性率随宫颈病变的加重而升高。MCM2与HR-HPV间的表达,具有显著意义的一致性(χ2=15.28,P<0.05)。183例患者中,MCM2和HR-HPV及二者联合筛查CINⅡ及以上病变的灵敏度分别为93.81%,88.66%和97.94%,特异性分别为88.00%,77.55%和91.67%。而在83例ASCUS中,MCM2和HR-HPV及二者联合筛查CINⅠ及以上病变的灵敏度分别为72.09%,62.79%和86.05%,特异性分别为67.57%,55.56%和66.67%,对筛查CINⅡ及以上病变的灵敏度分别为86.36%,68.18%和90.90%,特异性分别为91.89%,80.56%和88.89%。结论 MCM2在宫颈癌和癌前病变中高表达,与HR-HPV的表达相一致。MCM2免疫细胞化学检测优于HR-HPV检测,可作为ASCUS管理和宫颈癌及癌前病变筛查的辅助性标志物,二者联合应用能提高诊断的灵敏度和特异性,但在ASCUS管理上MCM2免疫细胞化学检测的特异性更高。Objective To explore the expression and clinical significance of minichromosome maintenance protein 2 （MCM2） in cervical lesions and its relationship with human papillomavirus （HPV） infection. Methods From October 2011 to December 2012, a total of 183 cases of cervical lesions suffered from Thinprep liquid-based cytology test （TCT） and the expressions of 13 kinds of high-risk HPV （HR- HPV） types were detected. Meanwhile, MCM2 immunocytochemical test was performed on liquid-based pap smears from the 183 remained TCT samples. Those results were compared with the cervical histopathology results. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Affiliated Hospital of Inner Mongolia Medical University. Informed consent was obtained from all participates. Results The positive expression rate of MCM2 and HR-HPV were raised accompanying with the severity of cervical lesions. MCM2 expression with HR-HPV had significant consistency （P〈0.05）. In 183 cases, the sensitivity of MCM2, HR- HPV types and the combination for detecting the CIN Ⅱ or worse were 93.81%, 88.66% and 97. 94%, the specificity were 88.0%, 77. 55% and 91.67%, respectively. While in 83 ASCUS cases, the sensitivity of MCM2, HR- HPV and the combination for detecting the CIN Ⅱ or worse were 72.09%, 62. 79% and 86.05%, the specificity were 67.57%, 55.56% and 66.67%, respectively. Whereas the sensitivity of them for detecting the CINⅡ orworse were 86.36%, 68.18% and 90.90%, the specificity were 91.89%, 80.56% and 88.89%, respectively. Conclusions In cervical carcinoma and precancerous lesions, MCM2 is overexpressed and consistent with the HR-HPV expression. As MCM2 immunoeytoehemical detection is better than HR-HPV detection, MCM2 may serve as a useful marker in the screening of cervical carcinoma and precancerous lesions and help in further upgrading the diagnosis of ASCUS. The joint application can improve the sensitivity and specificity of diagnosis, but in ASCUS management MCM2 immunocy

关 键 词：微小染色体维持蛋白2 人乳头瘤病毒 细胞学技术 宫颈肿瘤 

分 类 号：R737.33[医药卫生—肿瘤]