CK17在HR-HPV感染的宫颈病变组织的表达及意义

发布时间：2018-01-17 03:09

  本文关键词：CK17在HR-HPV感染的宫颈病变组织的表达及意义　出处：《皖南医学院》2014年硕士论文　论文类型：学位论文

  更多相关文章： HR-HPV CK17 宫颈病变 免疫组织化学

【摘要】：目的：1.了解宫颈组织中HPV的感染情况，探讨HPV分型检测在宫颈病变中的临床意义,并结合TCT检查结果评估宫颈癌的筛查方案；2.观察CK17在正常宫颈组织及宫颈病变组织中的表达，结合宫颈HPV感染情况，分析其在HR-HPV感染的宫颈组织中的表达情况及规律，初步探讨CK17的表达与高危型HPV（HR-HPV）感染的关系,以及其异常表达在预测宫颈病变发展中的临床意义。方法：1.运用导流杂交基因芯片技术（flow-through hybridization and gene chip）进行HPV分型检测，结合病理诊断结果，分析比较新柏氏液基细胞学检查（Thin-prepliquid-based Cytology Test，TCT）、HR-HPV检测对高级别宫颈病变的诊断效率。2.用免疫组织化学法检测各种宫颈组织中CK17蛋白的表达情况，以及感染HR-HPV亚型患者宫颈组织中CK17蛋白的表达情况。3.运用相关性分析探讨CK17表达与HR-HPV感染的相关性。结果：1.在所研究的142例患者中，HR-HPV总的感染率79.58%（113/142），CK17的阳性表达率为62.67%（65/142），其中HR-HPV阳性组中CK17的阳性表达率为53.1%(60/113), HR-HPV阴性组中CK17的阳性表达率为17.2%（5/29），表达差异具有统计学意义（X2=11.95,P＜0.05）；根据病理结果将本实验142例患者分为A、B、C、D四组，A组为经病理诊断均为慢性宫颈炎的患者组，有48例；B组为经病理诊断为宫颈上皮内瘤变Ⅰ级（CINⅠ）的患者组，共17例；C组为经病理诊断为宫颈上皮内瘤变Ⅱ-Ⅲ级（CIN Ⅱ/Ⅲ）的患者组，共63例；D组为经病理诊断为宫颈浸润癌（SCC）的患者组，共14例。在A、B、C、D四组中，CK17的阳性表达率逐渐增高，分别为2.08%（1/48）、23.53%（4/17）、76.19%（48/63)、85.71%（12/14)，统计结果表明，CK17在四组宫颈组织中的表达差异具有统计学意义（X2=72.78,P＜0.05）。2. A、B、C、D四组中HR-HPV的感染率分别为64.6%(31/48)、76.5%(13/17)、88.9%(56/63)、92.9%(13/14)，C、D组HR-HPV感染率高于A组和B组，差异有统计学意义（P＜0.05）；根据相关性分析，CK17蛋白的阳性表达率与HR-HPV的感染率呈正相关关系（ｒ=0.98,P＜0.05）。 3.单独以HR-HPV检测作为预测高级别宫颈上皮内瘤变的敏感性为89.6%,特异性为32.3%，阳性预测值为61.1%，阴性预测值为72.4%；单独以TCT≥ASCUS预测高级别宫颈病变的敏感性为87.0%，特异性为53.8%，阳性预测值为69.1%，，阴性预测值为77.8%；HR-HPV联合TCT对诊断高级别宫颈病变的敏感性为98.6%，特异性为17.4%，阳性预测值为58.5%，阴性预测值为91.7%。 结论：1.随着宫颈上皮内瘤变级别的升高，CK17的阳性表达呈上升趋势，CK17可能在宫颈病变的发生发展中发挥一定的作用；2.CK17的阳性表达率与HR-HPV的感染率呈正相关关系，CK17可能在HR-HPV感染诱发的宫颈病变的机制中发挥了作用；3.HPV分型检测可以了解与宫颈癌发生密切相关的高危型病毒，联合HR-HPV检测及宫颈TCT检查仍是目前较好的宫颈癌及宫颈癌前病变的筛查方案。
[Abstract]:Objective 1. To understand the infection of HPV in cervix tissues, to explore the clinical significance of HPV typing in cervical lesions, and to evaluate the screening scheme of cervical cancer with the results of TCT. 2. To observe the expression of CK17 in normal cervical tissues and cervical lesions, and to analyze the expression and regularity of CK17 in cervical tissues infected with HR-HPV combined with the situation of cervical HPV infection. To explore the relationship between the expression of CK17 and high risk HPV-HR-HPV-infection. The clinical significance of its abnormal expression in predicting the development of cervical lesions. Methods: 1.Using diversion hybridization gene chip technique (. Flow-through hybridization and gene chip-based HPV typing was performed. Combined with pathological diagnosis, the Thin-Prepliquid-based Cytology TestTCTs were analyzed and compared. The efficiency of HR-HPV in the diagnosis of high grade cervical lesions. 2. Immunohistochemical method was used to detect the expression of CK17 protein in various cervical tissues. And the expression of CK17 protein in cervical tissues of patients infected with HR-HPV subtype. 3. The correlation between CK17 expression and HR-HPV infection was studied by correlation analysis. Results:. 1. Of 142 patients studied. The total infection rate of HR-HPV was 79.58% and the positive rate of CK17 was 62.67% (65 / 142). The positive expression rate of CK17 in HR-HPV positive group was 53.1% / 113%. The positive expression rate of CK17 in HR-HPV negative group was 17. 2 / 29, and the difference was statistically significant (P < 0. 05). According to the pathological results, 142 patients were divided into four groups: group A (n = 48) and group A (n = 48) with chronic cervicitis diagnosed pathologically. Group B (17 cases) was diagnosed as cervical intraepithelial neoplasia grade 鈪

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