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目的:观察人白细胞相关抗原I(human leukocyte antigen class I,HLA-I)表达与维吾尔族妇女宫颈癌前病变进程及高危型HPV16的关系。方法:收集维吾尔族妇女宫颈炎、宫颈内上皮瘤样病变(cervical intraepithelial neoplasia,CIN)和宫颈鳞癌患者的石蜡包埋组织标本共148例,提取组织DNA,应用PCR的方法检测HPV阳性及HPV16型别;同时采用免疫组织化学SP法检测HLA-I蛋白表达水平。结果:(1)在维吾尔族妇女中HLA-I抗原在宫颈炎、CINI-II、CINIII、SCC组中阳性表达逐渐减少,差异有统计学意义(P<0.001)。(2)HLA-I的阳性表达下降趋势与宫颈癌临床分期、组织分化程度和淋巴结转移密切相关。(3)HPV在宫颈炎、CINI-II、CINIII、宫颈癌中的感染率分别为13%、46%、82%、95%,差异有统计学(P<0.001)。(4)HPV16在宫颈炎、CINI-II、CINIII、宫颈癌中的感染率分别为4%、30%、68%、85%,差异有统计学(P<0.001)。(5)在HPV16阳性标本中,存在HLA-I表达缺失的占71%(58/82),HPV16感染与HLA-I表达呈负相关(r=-0.625,P<0.001)。结论:(1)HLA-I表达缺陷可能是宫颈病变进展的重要标志,对宫颈癌的预测预警提供依据。(2)HPV16感染在宫颈病变的发展过程中起到了极大的促进作用,是一个很强的致癌因素。(3)HPV16感染与HLA-I表达之间的关系对揭示宫颈癌发病机制提供了客观依据。
Objective: To observe the relationship between the expression of human leukocyte antigen class I (HLA-I) and the progression of cervical precancerous lesions and high-risk HPV16 in Uighur women. Methods: A total of 148 Uyghur women with cervicitis, cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma were enrolled in this study. DNA was extracted from the samples and HPV positive and HPV16 were detected by PCR Type; at the same time using immunohistochemical SP method to detect HLA-I protein expression levels. Results: (1) The positive expression of HLA-I antigen in cervicitis, CINI-II, CINIII and SCC patients in Uighur women gradually decreased, the difference was statistically significant (P <0.001). (2) The declining trend of HLA-I positive expression is closely related to the clinical stage, histological differentiation and lymph node metastasis of cervical cancer. (3) The infection rates of HPV in cervicitis, CINI-II, CINIII and cervical cancer were 13%, 46%, 82% and 95%, respectively. The difference was statistically significant (P <0.001). (4) The infection rates of HPV16 in cervicitis, CINI-II, CINIII and cervical cancer were 4%, 30%, 68% and 85%, respectively. The difference was statistically significant (P <0.001). (5) Among the HPV16 positive samples, there were 71% (58/82) of the deletion of HLA-I expression. HPV16 infection was negatively correlated with HLA-I expression (r = -0.625, P <0.001). Conclusion: (1) The expression of HLA-I may be an important marker of cervical lesions, providing a basis for the prediction of cervical cancer. (2) HPV16 infection plays a great role in the development of cervical lesions and is a strong carcinogen. (3) The relationship between HPV16 infection and HLA-I expression provides an objective basis for revealing the pathogenesis of cervical cancer.