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目的探讨人宫颈癌基因(human cervical cancer oncogene,HCCR)在宫颈上皮内瘤变(CIN)和宫颈鳞癌(SCC)中的表达及其与HPV16整合状态的关系。方法选取2013年1月-2015年3月收治的HPV16阳性宫颈炎患者20例、CIN患者44例和SCC患者20例。采用多重实时PCR技术检测宫颈脱落细胞中的E2和E6基因,通过E2/E6比值,评估HPVl6型DNA的体内整合状态。采用免疫组化SP法测定各组患者宫颈脱落细胞HCCR表达情况。结果宫颈炎、CIN和SCC组HPV16 DNA游离型分别是95.00%(19/20)、43.18%(19/44)和15.00%(3/20),HPV16 DNA混合型分别是5.00%(1/20)、50.00%(22/44)和55.00%(11/20),HPV16 DNA整合型分别是0、6.82%(3/44)和30.00%(6/20),各组间比较,差异有统计学意义(P<0.05);在HPV16 DNA游离型及混合型组患者中,宫颈炎、CIN和SCC组HCCR表达逐渐增加,差异有统计学意义(P<0.05)。SCC组HPVl6DNA整合状态与年龄、临床期别、分化程度及淋巴结转移无关。结论 HPV感染可能与HCCR及HPV16整合状态有关,HCCR及HPV16存在状态检测可能作为细胞学筛查的一种补充手段,以期早发现CIN及SCC的高危患者。
Objective To investigate the expression of human cervical cancer oncogene (HCCR) in cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (SCC) and its relationship with the status of HPV16 integration. Methods Twenty patients with HPV16 positive cervicitis, 44 patients with CIN and 20 patients with SCC were selected from January 2013 to March 2015. Multiple real-time PCR was used to detect E2 and E6 genes in exfoliated cells of the cervix. The E2 / E6 ratio was used to assess the in vivo integration status of HPV16 DNA. Immunohistochemical SP method was used to detect the expression of HCCR in cervical exfoliated cells in each group. Results Cervitis, CIN and SCC were 95.00% (19/20), 43.18% (19/44) and 15.00% (3/20), respectively. HPV16 DNA hybrids were 5.00% (1/20 ), 50.00% (22/44) and 55.00% (11/20) respectively. The HPV16 DNA integration rates were 0,6.82% (3/44) and 30.00% (6/20), respectively (P <0.05). The HCCR expression in cervicitis, CIN and SCC groups was gradually increased in HPV16 DNA-free and mixed-type groups (P <0.05). The integration status of HPV16 DNA in SCC group was not related to age, clinical stage, differentiation and lymph node metastasis. Conclusion HPV infection may be related to the status of HCCR and HPV16 integration. The presence of HCCR and HPV16 may be a supplementary method for cytological screening in order to detect early high-risk patients with CIN and SCC.