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目的:研究子宫颈病变中人乳头瘤病毒(HPV)感染与FHIT蛋白表达的相关性,探讨HPV(+)患者如何进一步分流。方法:选择宫颈病变患者300例(慢性宫颈炎50例,CIN170例,宫颈鳞状细胞癌80例),取宫颈脱落细胞采用杂交捕获2代(HCⅡ)方法定量检测宫颈HPV DNA的含量,采用免疫组化Powervision法检测FHIT蛋白的表达情况,所得结果用SPSS 14.0统计软件进行卡方检验并计算P值。结果:①慢性宫颈炎、CINⅠ、CINⅡ/Ⅲ(包括原位癌)和浸润鳞癌各组HPV的阳性率分别为32.00%、45.83%、71.76%和95.00%,组间差异有统计学意义(P<0.01);②各组病毒负荷量(以RLU/CO表示)均值分别为133.57、344.96、536.06和623.02,HPV病毒负荷量不完全随着病变程度加重而增加(P>0.05);③FHIT蛋白在慢性宫颈炎、CIN及宫颈鳞癌中的低表达率分别为8.00%、43.53%、85.00%,三者比较差异有显著统计学意义(P<0.01);④FHIT蛋白低表达主要发生在HPV(+)病例,且随病变加重而升高。结论:①HPV DNA检出率随宫颈病变的严重程度而增加,但HPV DNA病毒负荷量与宫颈病变的严重程度不完全相关。②FHIT蛋白低表达率与HPV DNA检出率呈正相关,亦随宫颈病变程度加重而增加,且FHIT蛋白低表达主要发生在HPV阳性病例,与HSIL及宫颈癌的关系更为密切,提示FHIT蛋白可作为对HPV(+)患者进一步分流的分子生物学指标。③HC(II)HPV-DNA与FHIT蛋白免疫组化染色联合检测,既能做到早诊早治,又能够避免过度治疗。
Objective: To study the correlation between human papillomavirus (HPV) infection and FHIT protein expression in cervical lesions and to explore how to further divert HPV (+) patients. Methods: 300 cases of cervical lesions were selected (chronic cervicitis 50 cases, CIN 170 cases, cervical squamous cell carcinoma 80 cases). The exfoliated cells of cervix were examined by hybridization for 2 generations (HC Ⅱ) to detect the content of HPV DNA in the cervix. The expression of FHIT protein was detected by immunohistochemistry and the results were analyzed by Chi-square test using SPSS 14.0 software and the P value was calculated. Results: ① The positive rates of HPV in chronic cervicitis, CINⅠ, CINⅡ / Ⅲ (including carcinoma in situ) and invasive squamous cell carcinoma were 32.00%, 45.83%, 71.76% and 95.00%, respectively. There was significant difference between the two groups (P <0.01); ② The mean viral load (RLU / CO) in each group was 133.57, 344.96, 536.06 and 623.02, respectively. The viral load of HPV was not increased completely with the severity of disease (P> 0.05) The low expression rates of FITC protein in chronic cervicitis, CIN and cervical squamous cell carcinoma were 8.00%, 43.53% and 85.00%, respectively (P <0.01) +) Cases, and increased with the increase of disease. Conclusions: ① The detection rate of HPV DNA increases with the severity of cervical lesions, but the load of HPV DNA viruses is not related to the severity of cervical lesions. ② The low expression rate of FITC protein was positively correlated with the detection rate of HPV DNA and also increased with the severity of cervical lesions. The low expression of FHIT protein mainly occurred in HPV positive cases, which was more closely related to HSIL and cervical cancer, suggesting that FHIT protein As a molecular biological indicator of further shunting of HPV (+) patients. ③HC (II) HPV-DNA and FHIT protein immunohistochemistry joint detection, both to do early diagnosis and treatment, but also to avoid over-treatment.