脱落细胞人乳头瘤病毒L1壳蛋白的半定量检测有助于宫颈病变的鉴别诊断  

Semi-quantitative detection of HPV L1 capsid protein in exfoliative cytological examination facilitates the differential diagnosis of cervical lesions

作　　者：徐小艳[1] 杨金花[1] 林妮[2] 杨广英[1] 

机构地区：[1]南方医科大学附属郑州人民医院病理科,河南郑州450000 [2]南方医科大学南方医院惠侨科,广东广州475000

出　　处：《细胞与分子免疫学杂志》2014年第11期1194-1197,共4页Chinese Journal of Cellular and Molecular Immunology

基　　金：河南省医学科技计划项目(201204127)

摘　　要：目的研究人乳头瘤病毒L1(HPV L1)壳蛋白的表达量与宫颈上皮内瘤变的关系及其临床意义。方法采用免疫细胞化学方法检测153例宫颈脱落细胞中HPV L1壳蛋白的表达,用ImagePro Plus图像分析软件对HPV L1壳蛋白阳性单位(PU)进行半定量检测,并以宫颈活检的组织病理学结果为确诊标准。结果 HPV L1壳蛋白PU在宫颈细胞学分类为正常/炎症、未知意义的不典型鳞状细胞(ASCUS)、低级别上皮内瘤变、高级别上皮内瘤变组别中定量结果依次为46.87±24.46、27.23±24.30、24.10±22.45、9.36±19.82,差异具有统计学意义(P<0.01);其PU在组织学正常/炎症、低级别上皮内瘤变、高级别上皮内瘤变分组中分别为41.30±26.66、24.84±22.18、8.69±19.20,差异具有统计学意义(P<0.01);HPV L1壳蛋白PU与宫颈疾病的严重程度在细胞学分组和组织学分组中均呈负相关(r=-0.458,r=-0.441,P<0.01)。在高危型HPV感染的细胞中,HPV L1壳蛋白PU在HPV16、HPV18中的含量低于其他分型,差异具有统计学意义(P<0.01),HPV L1壳蛋白PU与年龄无关(P>0.05)。结论半定量分析HPV L1壳蛋白在诊断宫颈癌前病变中具有一定的指导作用。Objective To evaluate the association of human papilloma virus（ HPV） L1 capsid protein expression levels with cervical intraepithelial neoplasia（ CIN） and its clinical significance. Methods Immunohistochemistry were performed to detect the expression of HPV L1 capsid protein in the cervical exfoliative cytological examination of 153 cases. The intensity（ positive unit,PU） was assessed semi-quantitatively using ImagePro Plus image analysis software. The results were evaluated based on histopathologic diagnosis of cervical biopsy. Results PU of HPV L1 capsid protein in different cytopathological groups,including normal /inflammation, atypical squamous cells of unknown significance（ ASCUS）, low-grade squamous intraepithelial lesion（ LSIL）,high-grade squamous intraepithelial lesion（ HSIL）,was 46. 87 ± 24. 46,27. 23 ± 24. 30,24. 10 ±22. 45,9. 36 ± 19. 82,respectively,and the differences were statistically significant（ P〈0. 01）. PU of HPV L1 capsid protein in different histopathological groups,including normal cervixes or chronic cervicitis,LSIL and HSIL,was 41. 30 ± 26. 66,24. 84 ± 22. 18,8. 69 ± 19. 20,respectively,and the differences were statistically significant（ P〈0. 01）. Patients with high-risk HPV16 and HPV18 had significantly lower PU of HPV L1 capsid protein than those with other high-risk HPV（ P〈0. 01）. PU of HPV L1 capsid protein were correlated negatively with both cytopathological groups and histopathological groups of cervical diseases（ r =- 0. 458,P〈0. 01 and r =- 0. 441,P〈0. 01,respectively）. PU of HPV L1 capsid protein was not associated with patients＇ age（ P〉0. 05）. Conclusion Semi-quantitative analysis of HPV L1 capsid protein expression can directly reflect the precancerous progression of cervical cancer.

关 键 词：宫颈癌 HPV L1壳蛋白 宫颈上皮内瘤变 HPV分型 半定量分析 

分 类 号：R711.74[医药卫生—妇产科学] R392.33[医药卫生—临床医学]