新疆妇女宫颈癌前病变中HPV L1壳蛋白表达与高危HPV型别的相关性研究

发布时间：2018-03-08 23:11

本文选题：人乳头瘤状病毒　切入点：L1壳蛋白　出处：《石河子大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：本研究通过检测新疆汉族、维吾尔族妇女不同HPV亚型宫颈癌前病变中L1蛋白的表达情况，了解新疆汉族、维吾尔族妇女宫颈癌前病变中不同HPV亚型L1蛋白的表达差异。方法：收集2012年9月至2013年6月新疆自治区人民医院宫颈活检结果为宫颈炎、CINI、CINII-III的HPVDNAHC2阳性的宫颈分泌物标本共248例，其中汉族、维吾尔族宫颈炎各48例、46例，，CINI各40例、30例，CINII-III各28例、56例。采用碱裂解法提取HPVDNA，使用潮州凯普人乳头状瘤病毒核酸扩增分型检测试剂盒对提取出的HPVDNA进行聚合酶链反应（Polymerasechainreaction，PCR）扩增和导流杂交方法检测HPV基因型，石蜡组织切片经二甲苯及梯度酒精脱蜡至水，后续具体操作按HPVL1检测试剂盒（美国爱迪旺斯）免疫组化法说明书进行检测HPVL1蛋白。结果：（1）在248例宫颈癌前病变标本中共检测出13种高危HPV亚型（HPV16，58，52，53，68，31，66，18，39，33，35，56，59），2种低危HPV亚型（HPV6，81），其中HPV16型在维吾尔族、汉族中所占比例最高，分别为68.97%和65.15%，其次为HPV58、HPV52、HPV53型，百分比分别为32.76%、27%、27%，24.14%、15.5%，17.24%、15.5%。而HPV18型较少。（2）在同一级别宫颈病变中汉族、维吾尔族HPVL1蛋白阳性表达率差异无统计学意义（P0.05）。汉族患者中慢性宫颈炎、CINI、CINII-III的HPVL1蛋白阳性表达率分别为50%，60%，21.43%，宫颈炎与CINI的差异无统计学意义（P0.05），CINI与CINII-III的HPVL1蛋白阳性表达率差异有统计学意义（P0.05）。维吾尔族患者中慢性宫颈炎、CINI、CINII-III的HPVL1蛋白阳性表达率分别为34.78%，46.67%，17.86%，宫颈炎与CINI的差异无统计学意义（P0.05），CINI与CINII-III的HPVL1蛋白阳性表达率差异有统计学意义（P0.05）。（3）维吾尔族HPV16、非HPV16高危亚型中HPVL1蛋白的表达率分别为23.26%(20/86)、43.48%(20/46)，差异有统计学意义（P=0.016），HPV16型中汉族与维吾尔族HPVL1蛋白的表达率分别为42.5%（34/80）、23.26%(20/86)，差异亦有统计学意义（P=0.008）。结论：（1）新疆维吾尔族妇女子宫颈癌中HPV感染以HPV16感染率最高，其次为HPV58，而HPV18型较少，与我国其他地区以HPV16、18型为主有差异，这就为HPV疫苗在新疆维吾尔族聚集地区的开发提供一定的理论依据。（2）随着CIN程度的加重，HPVL1蛋白的表达越来越低，差异有统计学意义，说明宫颈损伤的程度越重，HPV晚期蛋白L1的表达率越低，L1蛋白可作为判断HPV感染后病毒复制状态的有效指标。（3）维吾尔族中HPV16型L1蛋白的表达显著低于非HPV16高危亚型，HPV16感染率高可能是因为L1蛋白表达缺失，使机体无法产生免疫反应清除病变细胞，从而加剧了病变的进展，引发宫颈癌；（4）HPV16型中维吾尔族HPVL1蛋白阳性表达率显著低于汉族，提示HPVL1蛋白的表达缺失可能是维吾尔族宫颈病变患病率高于汉族的原因之一。
[Abstract]:Objective: to investigate the expression of L1 protein in different HPV subtypes of cervical cancer in Han and Uygur women in Xinjiang. Methods: from September 2012 to June 2013, a total of 248 cervical secretions were collected from cervical biopsies of Xinjiang Autonomous region people's Hospital. The cervical secretions were positive for CINII-III of CINII-III, including Han nationality. There were 48 cases of cervicitis in Uygur nationality and 46 cases of CINI each, and 30 cases of CINII-III and 56 cases of CINII-III respectively. HPVDNA was extracted by alkaline lysis method, and the extracted HPVDNA was detected by polymerase chain reaction using Kepu human papillomavirus nucleic acid amplification assay kit in Chaozhou. PCR amplification and diversion hybridization were used to detect HPV genotypes. Paraffin sections were dewaxed to water by xylene and gradient alcohol. The HPVL1 protein was detected according to the instructions of immunohistochemical method for HPVL1 detection kit (Adivence, USA). Results in 248 specimens of precancerous lesions, 13 high risk HPV subtypes were detected. HPV6 (HPV6) and HPV6 (HPV6), in which the HPV16 type is found in the Uygur ethnic group, The proportion of Han nationality was the highest, 68.97% and 65.15, respectively, followed by HPV58, HPV52, HPV53, and the percentages were 32.766.27 and 27.27, respectively. In the same grade of cervical lesions, the Han nationality, There was no significant difference in the positive expression rate of HPVL1 protein in Uygur patients (P 0.05). The positive expression rate of HPVL1 protein in chronic cervicitis of CINII-III was 50.60% and 21.433.There was no significant difference between cervicitis and CINI in HPVL1 protein expression of CINII-III and P0.05CINI. The positive expression rate of CINII-III in chronic cervicitis in Uygur patients was 34.78 ~ 46.67 and 17.86 respectively. There was no significant difference between cervicitis and CINI. There was significant difference in the positive expression rate of HPVL1 protein between CINI and CINII-III in Uygur nationality. (3) the expression rates of HPVL1 protein in HPV16 and non-HPV16 were 23.26 and 23.26, respectively. The difference was statistically significant between Han and Uygur. The expression rates of HPVL1 protein in HPV16 were 42.5%, 8023.26%, 2086%, respectively, and the difference was statistically significant. Conclusion in Xinjiang Uygur women, the infection rate of HPV16 is the highest, the next is HPV58, and the HPV18 type is less, which is different from other regions in China. This provides a theoretical basis for the development of HPV vaccine in Xinjiang Uygur gathering area. 2) with the severity of CIN, the expression of HPVL1 protein became lower and lower, and the difference was statistically significant. It indicated that the more serious the degree of cervical injury, the lower the expression rate of HPVL1 protein. The lower the expression rate of HPVL1 protein was, the lower the expression rate of HPVL1 protein could be as an effective index to judge the replication status of HPVL1 protein after HPV infection. (3) the high infection rate of HPV16 L1 protein in Uygur is significantly lower than that of non-#en1# high risk subtype HPV16, which may be due to the lack of L1 protein expression, which makes the body unable to produce immune response to clear the diseased cells, thus exacerbating the progression of the disease and causing cervical cancer. The positive expression rate of HPVL1 protein in Uygur nationality was significantly lower than that in Han nationality, suggesting that the loss of HPVL1 protein expression might be one of the reasons for the higher prevalence of cervical lesions in Uygur nationality than in Han nationality.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

【参考文献】