【摘要】 目的探讨宫颈脱落细胞中高危型人乳头瘤病毒和k-ras、c-myc基因表达及其与宫颈上皮内瘤变病变程度的相关性。方法选择2012年12月至2013年1月在舟山市妇幼保健院因液基细胞学检测(TCT)结果异常或HPV-DNA检测异常行阴道镜宫颈活检术的252例患者作为研究对象,术前取其宫颈脱落细胞,其中宫颈上皮内瘤变(CIN)患者164例、慢性宫颈炎患者48例及正常体检者40例。实时荧光定量核酸扩增检测系统(q PCR)检测高危型HPV-DNA,逆转录定量PCR(q RT-PCR)检测k-ras、c-myc m RNA表达,并分析其与CIN病变程度间的相关关系。结果 (1)高危型HPV-DNA和k-ras、c-myc m RNA在CINⅠ~Ⅲ级表达均较慢性宫颈炎及正常体检者高,在CINⅢ级表达较CINⅠ、Ⅱ级高,差异有统计学意义(P<0.05)。(2)CIN患者高危型HPV-DNA与k-ras m RNA呈明显相关(r=0.2507,P=0.0012),但与c-myc m RNA表达无明显相关(P>0.05)。(3)Logistic回归分析显示高危型HPV-DNA和k-ras、c-myc m RNA表达增高是致CIN发生的危险因素(P<0.05)。结论 CIN发生与高危型HPV感染和癌基因k-ras、c-myc m RNA表达增高有关,特别是CINⅢ级。检测高危型HPV-DNA和k-ras、cmyc m RNA对早期发现CIN和宫颈癌具有重要的临床意义更多还原

【Abstract】 Objective To study the expression of high risk human papilloma virus(HPV) type DNA and k-ras, Cmyc oncogene m RNA and their relationship with cervical intraepithelial neoplasia(CIN). Methods In 164 cases of CIN patients, 48 cases of chronic cervicitis and 40 cases of normal control, whose cervical exfoliated cell were collected.High risk HPV DNA was detected by q PCR while k- ras and c- myc m RNA were detected by q RT- PCR, then the relationship between them and CIN grade was analyzed. Results The expression level of high risk HPV-DNA, k-ras and c- myc m RNA were relatively higher in CIN Ⅰ ~ Ⅲ than in chronic cervicitis and normal control; they were especially higher in CIN Ⅲ than in CINⅠ, Ⅱ(P<0.05); the expression level of HPV-DNA had a significant correlation with level of k- ras m RNA(r=0.2507,P=0.0012)in CIN patients, but not with c- myc expression(P>0.05). Logistic regression analysis also showed that higher expression level of HPV- DNA and k-ras, c-myc m RNA were risk factors for CIN(P<0.05). Conclusion High-risk HPV infection and higher expression level of oncogene k-ras, c-myc m RNA are correlated with CIN, especially CIN Ⅲ. Detection of high-risk HPV-DNA, k-ras and c-myc m RNA has an important clinical value in the early diagnosis of CIN and cervical cancer.更多还原