人乳头瘤病毒16/18型E6和E7蛋白在宫颈上皮内病变中的表达水平及临床价值  

Expression level and clinical value of HPV-16/18 E6 and E7 proteins in cervical intraepithelial lesion

作　　者：原亚莉 贺桂芳[2] 马莉[2] 张浩军[3] 卞美璐[2] 杨文艳 张媛 YUAN Ya-li;CHEN Jing;MA Li(Department of Gynecology and Obstetrics,The First Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院妇产科,北京100016 [2]中日友好医院妇产科,北京100029 [3]中日友好临床医学研究所药理室 [4]北京大学中日友好临床医学院,北京100029

出　　处：《中日友好医院学报》2018年第6期352-355,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨HPV E6/E7蛋白在宫颈癌早期筛查方面的临床应用价值。方法:收集2015年11月～2017年11月间中日友好医院妇产科宫颈病变门诊就诊和住院的400例患者,选取其中53例HPV16/18型阳性患者检测E6和E7蛋白的表达,分析其表达水平与组织病理学符合情况。结果:HPV E6蛋白在炎症、CIN 1、CIN 2-3和宫颈癌中的阳性表达率为0、37.5%、64.0%和84.6%;HPV E7蛋白分别为14.3%、37.5%、80.0%和92.3%。随着病变级别增加,HPV E6/E7蛋白的阳性表达率显著增加(P<0.01)。HPV E6、E7蛋白检测的灵敏度(71.1%、84.2%)均高于LCT(63.2%),阳性预测值(90.0%、88.9%)均高于HPV-DNA检测(71.7%)。结论:HPV E6/E7蛋白可能成为高度鳞状上皮内病变及宫颈癌的早期检测标志物,其检测可能提高筛查的准确性。Objective:To explore the clinical value of HPV E6/E7 protein in early screening of cervical cancer.Methods:A total of 400 patients from the Department of Obstetrics and Gynecology of China-Japan Friendship Hospital between Nov.2015 and Nov.2017 were collected.Fifty-three cases among whom infected HPV 16/18 were selected to study the expression of E6 and E7 proteins by immunocytochemical staining.The expression of E6 and E7 proteins was compared with the histopathological results.Results:The positive expression rates of HPV E6 protein in inflammation,CIN1,CIN2-3 and cervical cancer cases were 0%,37.5%,64.0% and 84.6%,and those of HPV E7 protein were 14.3%,37.5%,80.0% and 92.3%,respectively.With the increase of the pathological grades,the positive expression rates of HPV E6/E7 protein gradually increased,and the difference of expression levels of different grades of cervical lesions(≤CIN1,≥CIN 2)was statistically significant(P<0.01).The sensitivity of HPV E6 and E7 protein detection was higher than that of LCT(71.1%vs 63.2%,84.2% vs 63.2%).The positive predictive value of HPV E6 and E7 proteins were higher than those of HPV-DNA(90.0% vs 71.7%,88.9% vs 71.7%).Conclusion:HPV E6/E7 oncoprotein may become an early detection marker for the high-grade squamous intraepithelial lesion and cervical carcinoma,and has a clinical advantage of high accuracy of screening.

关 键 词：宫颈肿瘤 宫颈上皮内瘤变 E6/E7癌蛋白 人乳头瘤病毒 免疫细胞化学 

分 类 号：R711.74[医药卫生—妇产科学]