目的探讨L1蛋白、HMGA1与CIN1转归的相互关系及其诊断价值,为预测CIN1病变趋势提供生物学指标。方法选取2009年7月至2012年2月在北京市垂杨柳医院就诊的CIN1患者115例(实际随访97例),以单纯随访作为治疗方案,采用非同位素核酸分子杂交与免疫细胞化学技术测定L1蛋白的表达,免疫组化法测定HMGA1的表达。于确诊后第6个月、12个月行TCT、HPV检测,任意一次复查中出现TCT≥ASCUS、HPV检测仍为阳性的患者,行阴道镜组织活检。以一年末随访结果评价L1蛋白、HMGA1蛋白的表达情况与病变转归的关系。结果①在CIN1一年随访过程中,退组11人,失访7人,有效随访97人,有效随访率84.3%。其中病变进展5例(5.2%),病变持续59例(60.8%),病变逆转33例(30.4%);②CIN1患者中,L1阳性表达59例,病变进展2例(3.4%),病变持续28例(47.5%)病变逆转29例(49.1%);L1阴性表达38例,病变进展3例(7.9%),病变持续31例(81.6%),病变逆转4例(10.5%)两者比较,差异有统计学意义(χ2=17.14,P<0.05);③HMGA1阳性表达36例,病变进展4例(11.1%),病变持续27例(75.0%),病变逆转5例(13.9%);HMGA1阴性表达61例,病变进展1例(1.6%),病变持续32例(52.5%),病变逆转28例(45.9%)两者比较,差异有统计学意义(χ2=13.51,P<0.05);④L1与HMGA1联合共有四种表达形式:L1(+)HMGA1(+)、L1(+)HMGA1(-)、L1(-)HMGA1(+)、L1(-)HMGA1(-),在CIN1病变进展、病变持续、病变逆转中分别占4.2%、75%、20.8%;2.9%、28.6%、68.5%;25%、75%、0;0、84.6%、15.4%(χ2=40.98 P<0.05)差异有统计学意义。结论 L1蛋白的阳性表达与CIN1进展趋势呈负相关,HMGA1蛋白的阳性表达与CIN1进展趋势呈正相关,比较单独的L1壳蛋白或HMGA1蛋白,L1壳蛋白及HMGA1蛋白的联合表达可更好的预测CIN1疾病的进程,L1、HMGA1的联合检测可能作为预测CIN1病变趋势的新指标。 Objective To explore the relationship between the expression of L1 protein, HMGA1 and CIN1 and their diagnostic value, and to provide biological indexes for predicting the tendency of CIN1 lesions. Methods A total of 115 CIN1 patients (97 cases were actually followed up) who were treated in Chuiyangliu Hospital of Beijing from July 2009 to February 2012 were enrolled in this study. Simple follow-up was used as the treatment protocol. Non-isotopic nucleic acid hybridization and immunocytochemistry Protein expression, immunohistochemical determination of HMGA1 expression. At the 6th and 12th months after the diagnosis, TCT and HPV tests were performed. TCT≥ASCUS and HPV test were still positive in any review. Colposcopy biopsy was performed. The results of follow-up at year-end evaluation of L1 protein, HMGA1 protein expression and the relationship between the outcome of the disease. Results ① During the one-year follow-up of CIN1, 11 patients were retreated and 7 patients were lost to follow-up. The effective follow-up was 97 and the effective follow-up rate was 84.3%. Among them, 59 (60%) had pathological changes and 33 (30.4%) had pathological changes; (2) 59 cases were positive for L1, 2 cases were pathological changes (3.4%) and 28 cases were persistent There were 29 cases (49.1%) with lesion reversal (47.5%), 38 cases with L1 negative expression, 3 cases with pathological changes (7.9%), 31 cases with lesions (81.6%) and 4 cases with lesions reversed (10.5% There were 36 cases (11.1%) with HMGA1 positive expression, 27 cases (75.0%) with pathological changes, 5 cases (13.9%) with reversal of lesions, HMGA1 negative There were 61 cases of pathological changes, 1 case of pathological changes (1.6%), 32 cases of pathological changes (52.5%) and 28 cases of pathological changes (45.9%), the difference was statistically significant (χ2 = 13.51, P <0.05) There are four forms of expression in combination with HMGA1: L1 (+) HMGA1 (+), L1 (+) HMGA1 (-), L1 (-) HMGA1 (+) and L1 (-) HMGA1 (- The lesions were continuous and the lesions were reversed in 4.2%, 75%, 20.8%, 2.9%, 28.6%, 68.5%, 25%, 75%, 0%, 0,84.6%, 15.4% (χ2 = 40.98, P <0.05) There is statistical significance. Conclusion The positive expression of L1 protein is negatively correlated with the development trend of CIN1. The positive expression of HMGA1 protein is positively correlated with the development trend of CIN1. The expression of L1 capsid protein and HMGA1 protein can be better predicted than the single L1 protein or HMGA1 protein CIN1 disease progression, combined detection of L1, HMGA1 may be used as a new indicator to predict the trend of CIN1 lesions.