【摘要】 目的探讨高危型人乳头瘤病毒(HPV)载量和P16蛋白表达联合预测蒙古族宫颈上皮内瘤变Ⅰ级(CINⅠ)患者病变转归的价值。方法选取118例蒙古族CINⅠ患者,均采用第二代杂交捕获法检测宫颈组织中高危型HPV载量,采用免疫组化法检测宫颈组织中P16蛋白的表达情况。对患者进行随访,记录病变组织学转归。分析高危型HPV载量和P16蛋白表达与CINⅠ患者组织学转归的关系,采用受试者工作特征曲线评价两者单独和联合预测病变进展的效能。结果 (1)118例蒙古族CINⅠ患者高危型HPV阳性率为70.34%(83/118),P16蛋白阳性率为39.83%(47/118),且高危型HPV载量与P16蛋白表达分级呈正相关(P<0.05)。(2)随访24个月,CINⅠ总进展率为11.86%(14/118)。随着高危型HPV载量增加和P16蛋白表达分级升高,CINⅠ患者病变进展率有增高的趋势(均P<0.05)。(3)高危型HPV载量≥100 RLU/CO联合P16蛋白表达评分≥6分预测蒙古族CINⅠ患者病变进展的曲线下面积更大,灵敏度、特异度、阳性预测值、阴性预测值均较高(分别为0.896、90.36%、93.84%、94.06%、90.11%)。结论高危型HPV载量和P16蛋白表达与蒙古族CINⅠ患者的病变转归密切相关,两者联合可以有效地预测病变进展。更多还原

【Abstract】 Objective To explore the value of high-risk human papillomavirus(HPV) load combined with P16 protein expression in predicting disease outcome of Mongolian patients with cervical intraepithelial neoplasia grade Ⅰ(CINⅠ). Methods Totally 118 Mongolian patients with CINⅠ were selected, and all underwent cervical high-risk HPV load detection by hybrid capture Ⅱ assay and cervical P16 protein expression detection by immunohistochemistry. Follow-up was conducted in the patients for recording the histological outcome of lesions. The relation of high-risk HPV load or P16 protein expression with histological outcome was analyzed in patients with CINⅠ, and receiver operating characteristic curve was used to assess the efficiency of the two indexes, alone or in combination, for predicting disease progression. Results(1)In the 118 Mongolian patients with CINⅠ, the HPV positive rate and the positive rate of P16 protein were 70.34%(83/118) and 39.83%(47/118), respectively, and a positive correlation was found between high-risk HPV load and P16 protein expression grade(P<0.05).(2)During the 24-month follow-up, the total progression rate of CINⅠ was 11.86%(14/118).With the increase of high-risk HPV load or P16 protein expression grade, the progression rate of disease tended to rise in CINⅠ patients(all P<0.05).(3)For predicting the disease progression of Mongolian patients with CINⅠ, the combination of high-risk HPV load ≥100 RLU/CO and P16 protein expression score ≥6 points yielded greater area under the curve, higher sensitivity, specificity, positive and negative predictive values(0.896, 90.36%, 93.84%, 94.06% and 90.11%, respectively). Conclusion High-risk HPV load and P16 protein expression are closely related to the disease outcome of Mongolian patients with CINⅠ, and the combined detection of the two indexes is effective in predicting disease progression.更多还原