目的:探索HPV16亚洲变异体E6 T178G及欧洲变异体E6 T350G,A442C与其他变异体致宫颈病变及机制的异同.方法:选取浦东新区人民医院门诊或住院患者中HPV16型单一阳性、宫颈细胞学正常的300例研究对象,予宫颈液基薄层细胞学检查(Thinprep cytologic test,TCT)采集宫颈脱落细胞,对其E2、E6、E7基因序列进行检测;1年后复查TCT、HPV,持续感染者再次基因测序明确HPV16变异体分型,并对持续感染者进行阴道镜活检后病理检查,对所有患者均用SP免疫组化法检测E7蛋白表达水平.结果:HPV16变异体持续感染1年后,292例成功测序的患者中,259例慢性宫颈炎,32例宫颈上皮内瘤变Ⅰ级(CINI),1例宫颈上皮内瘤变I级(CINII).E7蛋白在各种变异体感染的患者宫颈组织中均有表达,其在亚洲变异体及欧洲变异体感染组与其他变异体感染组之间表达无明显差异(P>0.05).结论:E7蛋白可能在HPV16变异体致宫颈病变的早期阶段即发挥作用,但E7蛋白可能并不是HPV16不同变异体致宫颈病变机制不同的参考指标.%Objective To explore the differences and similarities of the cervical lesions and mechanism between Asian variant E6 T178G and European variant E6 T350G, A442C and other variants. Methods We selected 300 clinic or hospitalized patients in our hospital during the period of May 2011 to October 2012. Cervical exfoliated cells were harvested by Thinprep cytologic test (TCT). A PCR sequencing assay was performed to detect HPV16 E2, E6 and E7 gene variants. One year later, the test was repeated. The patients with persistent infection underwent cervical biopsy by colposcopy for pathological examination. SP immunohistochemical method was applied to detect E7 protein expression level in all the patients. Results After one year, of 292 patients who were successfully sequenced, 259 were chronic cervicitis, 32 were cervical intraepithelial neoplasia grade I (CINI), and one was cervical intraepithelial neoplasia grade II (CINII). E7 protein expressed in each variant. But the expression of E7 protein in patients with different variant infection had no significant difference from each other. Conclusions E7 protein may be play a role in the early stages of HPV16?induced cervical lesions. But E7 protein may not be a reference index of the different carcinogenic mechanism between different HPV16 variants.
展开▼
