IMP3和HPV联合检测在宫颈上皮内瘤变筛查中的应用  

Cervical intraepithelial neoplasia screening with combined detection of IMP3 and HPV-DNA

作　　者：蒋欣[1] 张亚军[1] 江月[1] 程明达[1] 

机构地区：[1]连云港市妇幼保健院病理科,江苏连云港222006

出　　处：《诊断病理学杂志》2015年第9期554-557,共4页Chinese Journal of Diagnostic Pathology

基　　金：连云港市卫生局科研资助项目(1325)

摘　　要：目的观察胰岛素样生长因子2 mRNA结合蛋白3(IMP3)在宫颈上皮内瘤变(CIN)及宫颈鳞状细胞癌(CSCC)中的表达情况,探讨其作为宫颈病变筛查的临床意义。方法分别对230例宫颈各类病变采用免疫组化方法检测IMP3蛋白表达情况,并行人乳头状瘤病毒分型检测。结果 230例标本中,IMP3蛋白表达率为73.5%,低级别子宫颈上皮内瘤变(CIN-L)组与慢性宫颈炎组比较差异显著(P<0.05);高级别宫颈上皮内瘤变(CIN-H)组与CIN-L组比较差异显著(P<0.05);CSCC组与CIN-H组比较差异不显著(P>0.05)。230例人乳头状瘤病毒(HPV)组中,高危型HPV检出率为70.4%,低危型为10.4%。高危型HPV在慢性宫颈炎组、CIN组、CSCC组检出率逐渐升高,差异极显著(P<0.01),其中CIN-H组与CIN-L组比较差异不显著(P>0.05);CSCC组与CIN-H组比较差异亦不显著(P>0.05)。结论 IMP3蛋白的阳性率随着宫颈病变级别升高而增加,可预测病变的进展情况,高危型HPV感染与IMP3带状表达呈明显正相关(P<0.01),二者联合检测是宫颈CIN早期筛查的理想手段。Purpose To investigate the expression of insulin-like growth factor 2 mRNA-binding protein 3 （ IMP3 ） in cervical intraepithelial neoplasia （CIN） and cervical cancer, and to evaluate the clinical screening significance of IMP3 in cervical lesions. Methods Immunohistochemica] staining was used for detection of IMP3 protein expression in 230 cases of various cervical lesions. Quick nuclear hybridization method was used for detection of high-risk HPV. The data were analysed by SPSS software. Results In 230 various cervical lesions, the expression rate of IMP3 was 73 %. In CIN-L, IMP3 expression rate was significantly higher than chronic cervicitis tissue （ P 〈 0. 05 ） ; In CIN-H, IMP3 expression rate significantly higher than CIN-L （ P 〈 0. 05 ）. In CSCC, IMP3 expression rate had no significant difference from CIN-H （ P 〉 0. 05 ）. In 230 various cervical lesions, high-risk HPV infected rate was 70. 4% and low-risk HPV infected rate was 10. 4%. The frequency of high-risk HPV in chronic cervicitis, CIN and CSCC tissue was significantly higher （ P 〈 0. 01 ） and no difference was observed between CIN-L and CIN-H （P 〉 0. 05）. The frequency of high-risk HPV in CSCC had no significant difference from CIN-H （ P 〉 0. 05 ）. Conclusion The positive rate of IMP3 increases with the cervical lesion grade which makes it a screening test marker for CIN and may help to determine the progressive potential of individual lesions. A band-like pattern of IMP3 staining is strongly associated with high-risk HPV infection （ P 〈 0. 01 ）. The detection of HPV and IMP3 can be used as an ideal tumor index for early cervical intraepithelial neoplasia screening.

关 键 词：宫颈上皮内瘤变 IMP3 高危型人乳头状瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]