【摘要】 目的研究肿瘤蛋白标志物、人乳头瘤病毒(HPV)感染在宫颈病变中的表达情况,并分析肿瘤蛋白标志物与HPV感染交互作用对不同程度宫颈病变的影响。方法共纳入经手术治疗或宫颈活检的116名患者作为研究对象,进行HPV、免疫组化SIRT1、P16和Ki67检测。对上述患者进行病理诊断并分类,其中宫颈炎患者20人、低级别上皮内瘤变(LSIL)32人、高级别上皮内瘤变(HSIL)44人和宫颈鳞癌20人。采用χ2检验或确切概率法分析4种因子的表达情况,Logistic回归模型分析肿瘤蛋白标志物与HPV感染交互作用在宫颈病变发展中的发病风险。结果随着疾病的发生进展,HPV阳性检出率、SIRT1、P16和Ki67的阳性率逐渐增高(所有P值均<0.01)。Logistic回归模型显示HPV分别与SIRT1和Ki67存在病毒-肿瘤蛋白表达的交互作用,导致LSIL向HSIL发展过程中的发病风险增加(P值均<0.01)。SIRT1、P16和Ki67之间的交互作用也在宫颈上皮内瘤变恶化过程中发挥着重要作用(P值均<0.01),SIRT1-HPV和HPV-Ki67的病毒-肿瘤蛋白表达的交互作用是HSIL向宫颈鳞癌恶化的重要危险因素(P值均为0.045)。结论 HPV与SIRT1和Ki67存在病毒-肿瘤蛋白表达的交互作用,在宫颈疾病发生发展中起着重要的作用。更多还原

【Abstract】 ObjectiveTo investigate the expression of tumor protein markers and human papillomavirus(HPV) infection in women with cervical lesions, and analyze the interaction between tumor protein markers and HPV infection on different degrees of cervical lesions.MethodsA total of 116 women,underwent surgical treatment or cervical biopsy,were enrolled. HPV genotyping and Sirtuin 1(SIRT1),P16 and Ki67 immunohistochemistry were tested. According to pathological diagnosis and classification,116 women were divided into chronic inflammation(20 patients),low-grade squamous intraepithelial lesions(LSIL)(32 patients), high-grade squamous intraepithelial lesions(HSIL)(44 patients) and cervical squamous cell carcinoma(20 patients). The Chi-square test/exact probability method was used to analyze the expression of the four factors, and the logistic regression model was used to determine the risk of interactions between tumor protein markers and HPV infection in the development of cervical lesions.ResultsWith the development of the disease, the positive rate of HPV, SIRT1, p16 and Ki67 was increased gradually(P<0.01). Logistic regression model showed that there were interactions of virus-tumor protein expression between HPV with SIRT1 and Ki67,which leads to an increased disease risk during the development of LSIL to HSIL(P<0.01). The interaction between SIRT1,P16 and Ki67 also played an important role in the progression of cervical intraepithelial neoplasia(P=0.045).ConclusionThe interactions of SIRT1-HPV and HPV-Ki67 are important risk factors for the occurrence and development of cervical diseases.更多还原