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目的探讨在宫颈上皮内瘤变(CIN)及宫颈癌组织中P16蛋白的表达与HPV感染的关系。方法选取65例宫颈癌石蜡标本及90例CIN标本(其中CINⅠ、CINⅡ、CINⅢ各30例)作为观察组,随机选取同期30例正常宫颈组织作为对照组。应用HPV分型检测试剂盒(PCR+膜杂交法)同时检测常见21种HPV亚型,观察宫颈病变不同级别中HPV感染及其亚型分布情况。结果在正常对照组、CIN组、宫颈癌组中,HPV的感染率三组间比较差异有统计学意义(P<0.05),而在CIN不同级别间差异无统计学意义。在HPV的分型检测中,单一感染排前5位的亚型依次为:16、58、18、52、39;混合感染以高危型混合感染为主。随着P16表达强度增高,HPV的感染率随之增高。进一步比较HPV分型与P16蛋白表达的关系,发现HPV16型和高危混合型在P16阴性和阳性比较中差异有统计学意义(P均<0.05)。结论随着宫颈病变级别的升高,HPV感染的阳性率也增高,HPV感染在本组病例中有型别差异,以16型为主,应重点防治。P16检测对宫颈病变合并HPV感染病例预后及转归具有一定的提示。
Objective To investigate the relationship between P16 protein expression and HPV infection in cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods 65 cases of cervical cancer paraffin specimens and 90 cases of CIN specimens (including CINⅠ, CINⅡ and CINⅢ, 30 cases) were selected as the observation group. 30 cases of normal cervical tissue were randomly selected as the control group. A total of 21 HPV subtypes were detected simultaneously by HPV typing test (PCR + membrane hybridization), and the HPV infection and its subtypes in different grades of cervical lesions were observed. Results The infection rates of HPV in the normal control group, CIN group and cervical cancer group were significantly different among the three groups (P <0.05), but there was no significant difference among the different grades of CIN. In HPV genotyping test, the top five subtypes of single infection were as follows: 16, 58, 18, 52, 39; mixed infections were mainly high-risk mixed infections. As the expression of P16 increased, the infection rate of HPV increased accordingly. Further comparison between the HPV type and the expression of P16 protein found that the HPV16 type and high risk mixed type in P16 negative and positive differences were statistically significant (P all <0.05). Conclusion With the increase of cervical lesions, the positive rate of HPV infection also increased. HPV infection in this group of patients there are type differences, with 16 type, should focus on prevention and treatment. P16 detection of cervical lesions with HPV infection prognosis and prognosis have some tips.