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目的:研究不同程度子宫颈病变中高危型人乳头瘤病毒HR-HPV感染和端粒酶活性的表达,以探讨两者在宫颈癌及宫颈上皮内瘤变中的作用及相关性。方法:采用第二代杂交捕获技术检测宫颈脱落细胞HPV-DNA含量,并用免疫组织化学EnVision二步法检测宫颈组织标本中端粒酶的表达。结果:(1)端粒酶阳性表达率在对照组、CINⅠ、CINⅡ、CINⅢ和宫颈癌组分别为10.00%、16.67%、40.00%、70.00%、95.00%,宫颈癌组高于CINⅢ,CINⅢ高于CINⅡ,CINⅡ高于CINⅠ,差异均有统计学意义(x2=4.329,P=0.037;x2=4.327,P=0.038;x2=4.022,P=0.045)。(2)随着宫颈病变级别的增加,高危型HPV的阳性率和病毒负荷量均增高。高危型HPV的阳性率在宫颈癌和CINⅢ组明显高于对照组、CINⅠ及CINⅡ(x2=29.501~7.414,P<0.01)。高危型HPV的病毒负荷量在对照组与其他4组比较,差异均有统计学意义(P<0.05);CINⅠ组分别与CINⅡ、CINⅢ及宫颈癌组比较差异均有统计学意义(P<0.05)。(3)随着宫颈病变级别的增加,高危型HPV的阳性率和端粒酶阳性表达率依次递增,两者有明显的相关性(r=0.943,P<0.01)。结论:高危型HPV感染和端粒酶活性均与宫颈癌前病变及宫颈癌的发生发展密切相关,有望作为子宫颈癌前病变和宫颈癌筛查的监测指标。
Objective: To study the expression of HR-HPV infection and telomerase activity in high-risk human papillomavirus (HPV) in cervical cancer patients with varying degrees of cervical cancer and cervical intraepithelial neoplasia. Methods: The second generation hybridization capture technique was used to detect the content of HPV-DNA in cervical exfoliated cells. The expression of telomerase in cervical tissues was detected by immunohistochemistry EnVision two-step method. Results: (1) The positive rate of telomerase in the control group was 10.00%, 16.67%, 40.00%, 70.00% and 95.00% respectively in the CINⅠ, CINⅡ, CINⅢ and cervical cancer groups, In CINⅡ, CINⅡwas higher than CINⅠ, the differences were statistically significant (x2 = 4.329, P = 0.037; x2 = 4.327, P = 0.038; x2 = 4.022, P = 0.045). (2) With the increase of cervical lesions, the positive rate of high-risk HPV and the viral load increased. The positive rate of high-risk HPV in cervical cancer and CINⅢgroup was significantly higher than that in control group, CINⅠ and CINⅡ (x2 = 29.501 ~ 7.414, P <0.01). The viral load of high-risk type HPV in the control group compared with the other four groups, the difference was statistically significant (P <0.05); CINⅠgroup and CIN Ⅱ, CIN Ⅲ and cervical cancer group differences were statistically significant (P <0.05 ). (3) With the increase of cervical lesions, the positive rate of high-risk HPV and the positive rate of telomerase increased in turn, with significant correlation (r = 0.943, P <0.01). CONCLUSION: Both high-risk HPV infection and telomerase activity are closely related to the development of cervical precancerous lesions and cervical cancer, which are expected to be used as monitoring indicators of cervical precancerous lesions and cervical cancer screening.