人乳头瘤病毒16/18型E6蛋白在宫颈病变中的意义及对预后的预测价值  

Expressions of HPV16/18 E6 protein and its clinical, predictive value of cervical intraepithelial neoplasia

作　　者：高华[1] 王云飞[2] 王文静[1] 张梅莹[1] 李青[1] 刘艺璇[1] 狄文[1] GAO Hua;WANG Yun-fei;WANG Wen-jing;ZHANG Mei-ying;LI Qing;LIU Yi-xuan;DI Wen(Shanghai Key Laboratory of Gynecologic Oncology,Department of Gynecology and Obstetrics,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Gynecology,Jining Medical University,Jining 272029,China)

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海市妇科肿瘤重点实验室,上海200127 [2]济宁医学院附属医院妇科,济宁272029

出　　处：《上海交通大学学报（医学版）》2018年第3期294-298,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生和计划生育委员会项目(20134205)

摘　　要：目的·探讨人乳头瘤病毒16/18型(HPV16/18)E6蛋白在不同级别宫颈病变组织中表达的临床意义及对疾病预后的预测价值。方法·采用免疫组化法检测10例正常宫颈组织、33例宫颈上皮内瘤变Ⅰ(cervical intraepithelial neoplasiaⅠ,CINⅠ)组织、31例CINⅡ?-?Ⅲ组织、30例宫颈癌手术病理标本中HPV16/18 E6蛋白的表达,分析其表达差异、与宫颈癌临床病理特征及不同CIN疾病进展之间的关系。结果·HPV16/18 E6阳性表达率在CINⅠ、CINⅡ?-?Ⅲ、宫颈浸润癌中依次增强(χ~2=19.82,P=0.000)。HPV16/18E6在低分化、直径大于4 cm的宫颈癌肿瘤中阳性表达率增高(P=0.033,P=0.011)。HPV16/18 E6过表达程度与宫颈癌病理学分级、肿瘤直径、不良预后之间成正相关(r=0.456,P=0.011;r=0.578,P=0.000;r=0.645,P=0.000)。HPV16/18 E6阳性表达对CINⅠ、CINⅡ?-?Ⅲ、宫颈癌进展预测的灵敏度分别为100.00%、62.50%、43.75%,特异度分别为96.77%、91.30%、92.86%,诊断符合率分别为96.97%、83.87%、66.67%。结论·HPV16/18 E6蛋白在宫颈癌发生发展及不良预后中发挥了重要作用,对宫颈疾病进展具有良好的预测价值,且对CIN疾病分层管理具有指导意义。Objective·To investigate the clinical significance and predictive value of human papillomavirus(HPV)16/18 E6 protein in the different cervical intraepithelial neoplasia.Methods·The expression of HPV16/18 E6 in 10 normal cervical tissues,33 cervical intraepithelial neoplasiaⅠ(CINⅠ),31 CINⅡ-Ⅲ,30 cervical cancers was detected by immunohistochemistry,explored the expression difference and the relationship with the clinicopathological characteristics of cervical cancer and the prognosis of different CIN.Results·The positive expression rates of HPV16/18 E6 in normal cervical tissues,CINⅠ,CINⅡ-Ⅲand cervical cancer group were up-regulated(χ2=19.82,P=0.000).HPV16/18 E6 increased positive expression rates in the low grade and the big size tumors of cervical cancer tissues were detected(P=0.033,P=0.011).There were positive correlations between the overexpression and the pathological grade,tumor size,poor prognosis of cervical cancers respectively(r=0.456,P=0.011;r=0.578,P=0.000;r=0.645,P=0.000).The sensitivity,specificity,and diagnostic accuracy rates of HPV16/18 E6 positive expression to the progression of CINⅠ,CINⅡ-Ⅲand cervical cancer were respectively 100.00%,62.50%,43.75%;96.77%,91.30%,92.86%;96.97%,83.87%,66.67%.Conclusion·HPV16/18 E6 overexpression plays an important role in the generation,development and the poor prognosis of cervical cancer.HPV16/18 E6 has a good predictive value for the prognosis and hierarchical management of cervical diseases.

关 键 词：人乳头瘤病毒 HPV16/18 E6 宫颈上皮内瘤样病变 宫颈癌 

分 类 号：R711.74[医药卫生—妇产科学]