上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (3): 294-.doi: 10.3969/j.issn.1674-8115.2018.03.010

• 论著（临床研究） • 上一篇    下一篇

人乳头瘤病毒 16/18 型 E6 蛋白在宫颈病变中的意义及对预后的预测价值

高华 1 ，王云飞 2 ，王文静 1 ，张梅莹 1 ，李青 1 ，刘艺璇 1 ，狄文 1   

  1. 1. 上海交通大学 医学院附属仁济医院妇产科，上海市妇科肿瘤重点实验室，上海 200127；2. 济宁医学院附属医院妇科，济宁 272029
  • 出版日期:2018-03-28 发布日期:2018-05-03
  • 通讯作者: ?狄 文，电子信箱：diwen163@163.com
  • 作者简介:高 华（1970—），女，副主任医师，博士；电子信箱：gaohua@renji.com。
  • 基金资助:
    上海市卫生和计划生育委员会项目（20134205）

Expressions of HPV16/18 E6 protein and its clinical, predictive value of cervical intraepithelial neoplasia

GAO Hua1 , WANG Yun-fei2 , WANG Wen-jing1 , ZHANG Mei-ying1 , LI Qing1 , LIU Yi-xuan1 , DI Wen1   

  1. 1. Shanghai Key Laboratory of Gynecologic Oncology, Department of Gynecology and Obstetrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2. Department of Gynecology, Jining Medical University, Jining 272029, China
  • Online:2018-03-28 Published:2018-05-03
  • Supported by:
    Foundation of Shanghai Municipal Commission of Health and Family Planning, 20134205

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摘要： 目的 · 探讨人乳头瘤病毒 16/18 型（HPV16/18）E6 蛋白在不同级别宫颈病变组织中表达的临床意义及对疾病预后的预测价值。方法 · 采用免疫组化法检测 10 例正常宫颈组织、33 例宫颈上皮内瘤变Ⅰ（cervical intraepithelial neoplasia Ⅰ，CIN Ⅰ）组织、31 例 CIN Ⅱ - Ⅲ组织、30 例宫颈癌手术病理标本中 HPV16/18 E6 蛋白的表达，分析其表达差异、与宫颈癌临床病理特征及不同 CIN 疾病进展之间的关系。结果 · HPV16/18 E6 阳性表达率在 CIN Ⅰ、CIN Ⅱ - Ⅲ、宫颈浸润癌中依次增强 (χ 2 =19.82，P=0.000)。HPV16/18 E6 在低分化、直径大于 4 cm 的宫颈癌肿瘤中阳性表达率增高 (P=0.033，P=0.011)。HPV16/18 E6 过表达程度与宫颈癌病理学分级、肿瘤直径、不良预后之间成正相关 (r=0.456，P=0.011；r=0.578，P=0.000；r=0.645，P=0.000)。HPV16/18 E6 阳性表达对 CIN Ⅰ、 CIN Ⅱ - Ⅲ、宫颈癌进展预测的灵敏度分别为 100.00%、62.50%、43.75%，特异度分别为 96.77%、91.30%、92.86%，诊断符合率分别为 96.97%、83.87%、66.67%。结论 · HPV16/18 E6 蛋白在宫颈癌发生发展及不良预后中发挥了重要作用，对宫颈疾病进展具有良好的预测价值，且对 CIN 疾病分层管理具有指导意义。

关键词: &ensp, 人乳头瘤病毒；HPV16/18 E6；宫颈上皮内瘤样病变；宫颈癌

Abstract:

Objective · To investigate the clinical significance and predictive value of human papillomavirus (HPV) 16/18 E6 protein in the different cervical intraepithelial neoplasia. Methods · The expression of HPV16/18 E6 in 10 normal cervical tissues, 33 cervical intraepithelial neoplasia Ⅰ(CIN Ⅰ), 31 CIN Ⅱ- Ⅲ , 30 cervical cancers was detected by immunohistochemistry, explored the expression difference and the relationship with the clinicopathological characteristics of cervical cancer and the prognosis of different CIN. Results · The positive expression rates of HPV16/18 E6 in normal cervical tissues, CIN Ⅰ, CIN Ⅱ-Ⅲ and cervical cancer group were up-regulated (χ 2 =19.82, P=0.000). HPV16/18 E6 increased positive expression rates in the low grade and the big size tumors of cervical cancer tissues were detected (P=0.033, P=0.011). There were positive correlations between the overexpression and the pathological grade, tumor size, poor prognosis of cervical cancers respectively (r=0.456, P=0.011; r=0.578, P=0.000; r=0.645, P=0.000). The sensitivity, specificity, and diagnostic accuracy rates of HPV16/18 E6 positive expression to the progression of CIN Ⅰ, CIN Ⅱ-Ⅲ and cervical cancer were respectively 100.00%, 62.50%, 43.75%; 96.77%, 91.30%, 92.86%; 96.97%, 83.87%, 66.67%. Conclusion · HPV16/18 E6 overexpression plays an important role in the generation, development and the poor prognosis of cervical cancer. HPV16/18 E6 has a good predictive value for the prognosis and hierarchical management of cervical diseases.

Key words: human papillomavirus (HPV), HPV16/18 E6, cervical intraepithelial neoplasia (CIN), cervical cancer