HPV L1壳蛋白、p16蛋白联合细胞学检测对宫颈SIL的检出能力分析  

Detection ability of HPV L1 capsid protein and p16 protein combined with cytologic test to detect cervical squamous intraepithelial lesion

作　　者：王青慧 郑小妹 万珍玲 赵晓红 张亚芳 WANG Qinghui;ZHENG Xiaomei;WAN Zhenling;ZHAO Xiaohong;ZHANG Yafang(Department of Obstetrics and Gynecology,Hainan Maternal and Children′s Medical Center,Hainan Haikou 570206,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Hainan Medical University,Hainan Haikou 570102,China)

机构地区：[1]海南省妇女儿童医学中心妇产科 [2]海南医学院第一附属医院妇产科

出　　处：《中国妇幼健康研究》2021年第10期1425-1430,共6页Chinese Journal of Woman and Child Health Research

基　　金：海南省基础与应用基础研究计划(自然科学领域)高层次人才资助项目(2019RC391)。

摘　　要：目的探讨人乳头瘤病毒(HPV)L1壳蛋白、p16蛋白联合液基薄层细胞学(TCT)在宫颈鳞状上皮内瘤变(SIL)中的检测价值。方法选取2018年1月至2020年12月在海南省妇女儿童医学中心治疗的宫颈病变患者210例为研究对象,根据病理检查结果分为慢性宫颈炎45例,SIL 136例(LSIL患者72例,HSIL患者64例),宫颈鳞状细胞癌(SCC)患者29例,所有患者均行TCT检查,分别采用免疫细胞化学和免疫组织化学方法检测HPV L1壳蛋白和p16蛋白。结果不同宫颈病变患者HPV L1壳蛋白阳性表达率比较差异有统计学意义(χ^(2)=71.694,P<0.01),进一步每两组间比较结果显示,HSIL患者HPV L1壳蛋白阳性表达率显著低于慢性宫颈炎和LSIL患者(χ^(2)值分别为19.207、35.743,P<0.01),SCC患者HPV L1壳蛋白阳性表达率显著低于慢性宫颈炎、LSIL患者和HSIL患者(χ^(2)值分别为34.380、50.625、9.426,P<0.01)。不同宫颈病变患者p16蛋白阳性表达率比较差异有统计学意义(χ^(2)=77.317,P<0.01),进一步每两组间比较结果显示LSIL患者p16蛋白阳性表达率显著高于慢性宫颈炎患者(χ^(2)=21.914,P<0.01),HSIL患者p16蛋白阳性表达率显著高于慢性宫颈炎和LSIL患者(χ^(2)值分别为53.889、12.106,P<0.01),SCC患者p16蛋白阳性表达率显著高于慢性宫颈炎、LSIL患者和HSIL患者(χ^(2)值分别为53.139、18.016、5.077,P<0.05),提示随着宫颈病变进展,p16蛋白阳性表达率逐渐升高。TCT联合HPV L1、p16诊断HSIL及以上病变的灵敏度和阳性预测值显著高于单独TCT检查(χ^(2)值分别为11.160、4.501,P<0.05),而特异度和阴性预测值显著低于单独TCT检查(χ^(2)值分别为6.710、5.293,P<0.05)。所有患者随访12个月后复诊,各组患者疾病进展情况比较差异有统计学意义(χ^(2)=31.248,P<0.01),进一步每两组间比较结果显示HPV L1(-)p16(+)表达患者疾病进展发生率显著高于HPV L1(-)p16(-)、HPV L1(+)p16(-)、HPV L1(+)p16(+)表达患者(χ^(2)值分别为21.30Objective To investigate the detection value of human papillomavirus(HPV)L1 capsid protein and p16 protein combined with thin-prep cytologic test(TCT)in cervical squamous intraepithelial lesion(SIL).Methods A total of 210 patients with cervical lesions treated in Hainan Maternal and Children′s Medical Center from January 2018 to December 2020 were selected as the research subjects,including 45 patients with chronic cervicitis,136 patients with SIL[72 patients with low-grade SIL(LSIL),64 patients with high-grade SIL(HSIL)]and 29 patients with cervical squamous cell carcinoma(SCC).All patients were treated with TCT,and the HPV L1 capsid protein and p16 protein were detected with immunocytochemistry and immunohistochemistry,respectively.Results The difference of positive expression rates of HPV L1 capsid protein in patients with different cervical lesions was statistically significant(χ^(2)=71.694,P<0.01).The results of further comparison between each two groups showed that the positive expression rate of HPV L1 capsid protein in HSIL patients was significantly lower than that in chronic cervicitis and LSIL patients(χ^(2)=19.207 and 35.743,respectively,P<0.01).The positive expression rate of HPV L1 capsid protein in SCC patients was significantly lower than that in chronic cervicitis,LSIL patients and HSIL patients(χ^(2)=34.380,50.625 and 9.426,respectively,P<0.01).The positive expression rate of p16 protein in patients with different cervical lesions was statistically significant(χ^(2)=77.317,P<0.01).The results of further comparison between each two groups showed that the positive expression rate of p16 protein in LSIL patients was significantly higher than that in patients with chronic cervicitis(χ^(2)=21.914,P<0.01).The positive expression rate of p16 protein in HSIL patients was significantly higher than that in chronic cervicitis and LSIL patients(χ^(2)=53.889 and 12.106,respectively,P<0.01).The positive expression rate of p16 protein in SCC patients was significantly higher than that in chronic cervic

关 键 词：人乳头瘤病毒 L1壳蛋白 P16蛋白 液基薄层细胞学 宫颈鳞状上皮内瘤变 

分 类 号：R737.33[医药卫生—肿瘤]