宫颈病变患者阴道微生态与高危型HPV感染及宫颈癌相关增殖基因表达的相关性

目的探讨宫颈病变患者阴道微生态与高危型HPV感染及宫颈癌相关增殖基因表达的相关性。方法选择2018年1月至2019年1月间在我院确诊为原发性宫颈癌的患者50例作为宫颈癌组,在我院诊断为宫颈糜烂的患者78例作为宫颈糜烂组,同期在我院进行体检的健康女性100例作为正常对照组。对比3组研究对象的阴道微生态失调率、高危型HPV感染率以及宫颈癌组、宫颈糜烂组患者宫颈病灶组织中宫颈癌相关增殖基因(Prdx4、Nek2、Fhit、BLCAP)mRNA表达量的差异。采用Pearson检验分析宫颈癌患者阴道微生态失调率与高危型HPV感染及宫颈癌相关增殖基因表达的相关性。结果宫颈癌组、宫颈糜烂组患者的阴道微生态失调率、高危型HPV感染率高于正常对照组,其中宫颈癌组患者这两项指标水平高于宫颈糜烂组(均P0.05)。宫颈癌组患者宫颈病灶组织中Prdx4、Nek2 mRNA表达量高于宫颈糜烂组,Fhit、BLCAP mRNA表达量低于宫颈糜烂组(均P0.05)。相关性分析发现,宫颈癌患者阴道微生态失调率与高危型HPV感染率呈正相关,与癌基因(Prdx4、Nek2)mRNA表达量呈正相关,与抑癌基因(Fhit、BLCAP)mRNA表达量呈负相关(均P0.05)。结论宫颈癌患者阴道微生态失调率较高,可能与高危型HPV感染及癌细胞增殖旺盛密切相关。     

miR-9靶向调控PTEN在HPV16+及HPV18+宫颈癌细胞凋亡中的作用

研究微小RNA-9(microRNA-9,miR-9)靶向调控人第10号染色体缺失的磷酸酶及张力蛋白同源蛋白（Recombinantphosphataseandtensinhomolog,PTEN）在人乳头瘤病毒（Humanpapillomavirus,HPV）16+及HPV18+宫颈癌细胞凋亡中的作用。收集宫颈癌组织及正常宫颈组织，培养HPV16+SiHa细胞、HPV18+HeLa细胞、HPV阴性C33A细胞及正常宫颈上皮H8细胞，检测miR-9、PTEN的表达水平。SiHa细胞和HeLa细胞进行分组转染后检测增殖抑制率、凋亡率、PTEN及miR-9表达水平。结果显示高危型HPV阳性及阴性的宫颈癌组织中miR-9的表达水平高于正常宫颈组织、PTEN的表达水平低于正常宫颈组织（P<0.05）且高危型HPV阳性宫颈癌组织中miR-9、PTEN表达的变化更显著；SiHa细胞、HeLa细胞中miR-9的表达水平高于C33A细胞和H8细胞、PTEN的表达水平低于C33A细胞和H8细胞（P<0.05）；敲低miR-9表达后，SiHa细胞、HeLa细胞的PTEN表达水平、增殖抑制率、凋...     

人乳头瘤病毒E7蛋白对细胞周期G1/S检查点的影响

高危型人乳头瘤病毒(HPV)感染与宫颈癌的发生关系已经明确,HPV编码的早期蛋白E7是HPV致宫颈癌的主要相关蛋白之一。G_1/S检查点是细胞周期中不可逆的关键点,决定了细胞进入细胞周期与否,与肿瘤的发生发展关系密切。pRb蛋白是调控细胞周期G_1/S检查点中的限速底物,是起调控作用的主要因子之一。E7通过影响pRb蛋白、E2F家族、Cyclin/CDK2复合物、p27蛋白、Dyrk1B等细胞周期相关蛋白来影响G_1/S检查点的正常工作,形成失控的细胞增殖。高危型HPV E7蛋白对细胞周期检查点的影响,既是HPV致癌机制的重要组成部分,也可能成为攻克此类癌症的突破口。本文综述了高危型HPV E7蛋白对细胞周期G_1/S检查点的影响。     

高危型HPV DNA整合导致宫颈癌的作用机制和临床检测进展

高危型人乳头瘤病毒(human papillomavirus,HPV)感染是宫颈癌发生发展的必要因素之一。病毒DNA整合到宿主基因组中被认为是导致宫颈癌最重要的病因。高危型HPV DNA整合往往导致其E1和E2区大部分缺失或中断,E6和E7致癌基因过表达,宿主致癌基因激活和抑癌基因失活。目前研究表明高危型HPV整合可作为优质宫颈病变筛查的预测生物标志物,且其检测的有效方法大都基于荧光原位杂交、实时荧光定量PCR和杂交捕获技术结合Sanger测序法等。本文重点阐述了高危型HPV整合导致宫颈癌的主要机制,描述了宫颈病变筛查标志物以及预防性HPV疫苗研发和推广的研究进展,并综述了高危型HPV DNA整合状态的检测方法。     

HPV及HLA与宫颈癌关系研究进展

宫颈癌是女性常见恶性肿瘤之一,HPV几乎是所有的宫颈鳞癌(95-100%)的致病因素.大量研究表明高危型HPV如HPV16、18的致癌性较低危型明显增高,E6、E7原癌蛋白分别与细胞内肿瘤抑制物p53和pRb结合使其失活是高危型HPV致癌的重要机制.肿瘤细胞往往是通过多种途径逃避免疫系统对他的识别及破坏,细胞表面HLAI类分子的表达尤为重要,这使得肿瘤细胞避免了细胞毒性T淋巴细胞对其的识别及溶解.HPIV病毒E6,E7,Li基因突变的研究表明特定位点的突变会使病毒更易诱导产生癌变及增大再次感染或从宿主免疫系统逃逸的机会;近年研究提出,宿主自身免疫遗传背景不仅参与病毒感染,而且参与肿瘤免疫,并在介导免疫识别、免疫应答、自然杀伤细胞自然杀伤作用和免疫调节力等方面发挥关键作用.深入探讨HPV病毒感染与人白细胞抗原(HLA)基因多态性的易感性、宫颈癌类型与人白细胞抗原(HLA)及其配体杀伤细胞免疫球蛋白样受体(KIR)易感性成为医学多学科共同研究的热点.现对HPV及HLA在宫颈癌发生中的免疫机制的研究进展给予综述.     

外周血Treg细胞、T淋巴细胞及其亚群与早期宫颈癌的关系及对淋巴结转移的预测价值研究

摘要 目的：分析外周血Treg细胞、T淋巴细胞及其亚群与早期宫颈癌的关系及对淋巴结转移的预测价值。方法：选择我院自2017年1月至2020年12月接诊的60例接受子宫颈癌根治术及盆腔淋巴清扫术的早期宫颈癌患者作为观察组,另选同期的60例健康体检者作为对照组。比较两组外周血Treg细胞、T淋巴细胞及其亚群水平,使用受试者工作特征曲线（ROC）下面积（AUC）评价外周血Treg细胞、T淋巴细胞及其亚群对淋巴结转移的预测效能。结果：观察组外周血Treg细胞、CD8⁺T细胞水平高于对照组,CD3⁺T细胞、CD4⁺T细胞、CD4⁺/CD8⁺比值均低于对照组（P＜0.05）;观察组术后外周血Treg细胞、CD8⁺T细胞水平较术前降低,CD3⁺T细胞、CD4⁺T细胞、CD4⁺/CD8⁺比值均较术前升高（P＜0.05）;在60例早期宫颈癌患者中,发生淋巴结转移12例;淋巴结转移组术前外周血Treg细胞水平、CD8⁺T细胞高于非淋巴结转移组,CD3⁺T细胞、CD4⁺T细胞、CD4⁺/CD8⁺比值均低于非淋巴结转移组（P＜0.05）;经多因素Logistic回归分析,外周血Treg细胞、CD3⁺T细胞、CD4⁺/CD8⁺比值均是早期宫颈癌患者发生淋巴结转移的独立预测因素（P＜0.05）;经ROC曲线分析,外周血Treg细胞、CD3⁺T细胞联合CD4⁺/CD8⁺比值预测早期宫颈癌患者发生淋巴结转移的AUC为0.910。结论：外周血Treg细胞、T淋巴细胞及其亚群水平与早期宫颈癌的病情演变有关,其中外周血Treg细胞、CD3⁺T细胞联合CD4⁺/CD8⁺比值预测淋巴结转移的效能较好,值得进一步研究应用。     

HPV16E7的表达对宫颈癌变过程中CD163+巨噬细胞的浸润及上皮间质转化的影响

目的 研究人乳头瘤病毒16E7(HPV16E7)、上皮间质转化(epithelial-mesenchymal transition,EMT)“cadherin switch”标记物E-cadherin、N-cadherin,及肿瘤相关巨噬细胞(tumor-associated macrophages,TAMs)标记CD163在宫颈癌变过程中的表达情况,探讨在不同的HPV16E7表达情况下,上皮间质转化程度及肿瘤相关巨噬细胞浸润的差异及二者之间的关系。方法 通过免疫组化法检测宫颈鳞状细胞癌、高级别上皮内瘤变(CINII-III)、低级别上皮内瘤变(CINI)及慢性宫颈炎患者的HPV16E7、E-cadherin、N-cadherin、CD163的表达情况。结果 E-cadherin的表达随着宫颈癌变的进展逐渐降低,N-cadherin的表达以及CD163+巨噬细胞数量随着宫颈病变的进展逐渐升高。慢性宫颈炎、CINI、CINII-III及宫颈鳞状细胞癌的HPV16E7阳性组和阴性组比较中,E-cadherin的表达在CINII-III及宫颈鳞状细胞癌中HPV16E7阳性组明显低于阴性组;N-cadherin的表达在宫颈鳞状细胞癌中HPV16E7阳性组明显高于阴性组;CD163+巨噬细胞数目在CINI、CINII-III及宫颈鳞状细胞癌中HPV16E7阳性组明显高于阴性组。进一步统计CD163+巨噬细胞与上皮间质转化间关系后发现,宫颈癌变过程中,随着CD163+巨噬细胞数目的增多,E-cadherin的表达逐渐降低,无论HPV16E7的表达如何,二者均呈负相关关系;宫颈鳞状细胞癌中,随着CD163+巨噬细胞数目的增多,N-cadherin的表达逐渐增加,HPV16E7阳性组二者仍呈正相关关系,而HPV16E7阴性组无明显相关关系。结论 HPV16E7可能通过肿瘤相关巨噬细胞来调节上皮间质转化的“cadherin switch”,从而促进宫颈癌的癌变。     

早期肠内营养制剂联合谷氨酰胺、低分子肝素对老年重症肺炎患者炎症程度、T淋巴细胞亚群分布及并发症发生率的影响

目的：探讨早期肠内营养制剂联合谷氨酰胺、低分子肝素对老年重症肺炎患者炎症程度、T淋巴细胞亚群分布及并发症发生率的影响。方法：选取2017年2月-2019年2月本院收治的老年重症肺炎患者90例作为研究对象,经随机数表法分为对照组、研究组各45例。对照组患者在常规治疗同时接受早期肠内营养制剂,研究组患者在对照组基础上加入谷氨酰胺、低分子肝素,持续1周后评估疗效。对比两组患者的治疗效果、血清炎症介质［高迁移率族蛋白（HMGB-1）、白介素-17（IL-17）、单核细胞趋化蛋白1（MCP-1）、C反应蛋白（CRP）、降钙素原（PCT）］及外周血T淋巴细胞亚群［CD3+、CD4+、CD8+T淋巴细胞、CD4+/CD8+比值］分布水平的差异,记录治疗期间药物相关不良反应、严重并发症的发生情况。结果：治疗1周后,研究组患者的总有效率高于对照组患者（P＜0.05）;血清中HMGB-1、IL-17、MCP-1、CRP、PCT的水平低于对照组患者;外周血中CD3+、CD4+T淋巴细胞分布水平及CD4+/CD8+比值大于对照组,CD8+T淋巴细胞分布水平低于对照组（P＜0.05）。治疗期间,两组恶心呕吐、头晕头痛、腹泻便秘、皮疹水泡发生率的差异无统计学意义（P＞0.05）;研究组患者的弥散内血管内凝血、脓毒症发生率低于对照组患者（P＜0.05）;两组间心力衰竭、死亡率差异无统计学意义（P＞0.05）。结论：老年重症肺炎患者在早期肠内营养制剂应用同时采用谷氨酰胺、低分子肝素进行联合干预,可积极提升疗效并均衡机体炎症反应、免疫紊乱,一定程度减少严重并发症发生。     

敲低肿瘤细胞来源的颗粒体蛋白前体抑制C57BL/6J小鼠黑色素移植瘤的生长

颗粒体蛋白前体 (progranulin, PGRN)在多种肿瘤中过表达。但PGRN在黑色素瘤发生发展中的作用尚无报道。为探究PGRN在黑色素肿瘤中的作用,本研究采用CRISPR-Cas9基因编辑技术建立了稳定敲低PGRN的小鼠黑色素瘤B16细胞株B16-PGRNlow。MTS法和BrdU掺入结合流式细胞（计量）术分析证明,敲低PGRN不影响B16细胞的细胞周期和增殖。将B16-ctrl（对照）和B16-PGRNlow细胞分别皮下接种野生型（WT）和PGRN敲除（KO）的C57BL/6J小鼠,比较观察黑色素移植瘤体积大小。移植瘤形成20 d后,与B16-ctrl细胞接种的移植瘤比较,无论在WT还是在KO荷瘤小鼠,B16-PGRNlow形成的移植瘤体积明显减小（WT鼠：P<0.05;KO鼠：P<0.01）。然而,比较B16-PGRNlow或B16-ctrl在WT鼠与KO鼠形成的移植瘤体积大小,并无显著差异,提示B16肿瘤细胞PGRN而非宿主PGRN影响移植瘤的生长。流式细胞术分析显示,在荷B16-PGRNlow移植瘤的WT型小鼠脾和淋巴结中,CD4+、CD8+T细胞数（百分比）比荷B16-ctrl移植瘤的WT鼠脾和淋巴结的CD4+、CD8+T细胞数明显增多（P<0.05,P<0.01）,而在KO鼠却未见明显差异。上述结果证明,敲低肿瘤细胞PGRN可抑制黑色素移植瘤的生长。上述结果还提示,抑制PGRN在黑色瘤的表达可引起脾和淋巴结CD4+和CD8+T细胞增加,提高宿主的细胞免疫能力。其机制尚待进一步研究。本文的发现为PGRN作为黑色素瘤治疗的潜在靶点提供了新证据。     

人腺病毒55型感染肺部病变与外周血淋巴细胞关系研究

目的:探讨人腺病毒55型感染肺部病变与外周血淋巴细胞改变的关系及致病意义。方法:以50例经胸部CT证实为腺病毒肺炎的患者为研究对象(肺炎组),调查其外周血细胞及T淋巴细胞亚群变化情况,并与同期腺病毒55型感染未出现肺部病变的患者30例(非肺炎组)对照;亚组分析50例肺炎组中多肺叶病变与单肺叶病变患者之间T淋巴细胞变化的差异。结果:与非肺炎组患者相比,肺炎组患者急性期外周血淋巴细胞比例明显降低、单核细胞比例明显升高(P0.01);肺炎组CD3+T淋巴细胞比例、CD3+CD4+T淋巴细胞比例及CD4/CD8比值较非肺炎组均有明显降低(P0.01)。亚组分析显示,肺炎组患者肺部病变范围不同,T淋巴细胞亚群的变化亦有差异,多肺叶病变组患者CD3+CD8+T淋巴细胞比例较单肺叶病变组明显升高、CD4/CD8比值较单肺叶病变组明显降低(P0.05)。结论:HAdv-55感染引起肺炎病变时,宿主存在明显的细胞免疫功能受损,且与肺部病变程度有一定正相关。     

CD4+ tumor-infiltrating lymphocytes in cervical cancer recognize HLA-DR-restricted peptides provided by human papillomavirus-E7.

Human papillomavirus (HPV)-encoded proteins may provide targets for CD8+ or CD4+ T lymphocytes infiltrating into cervical cancer. We established an MHC class II-restricted CD4+ T cell line from a patient with cervical cancer that recognizes autologous (HPV35+, HPV59+) cervical cancer cells and the HLA-DR4-matched cervical cancer cell line Me180 (HPV68+) as determined by TNF-alpha secretion. Expression of different HPV-E7 genes in autologous B cells revealed that this T cell line defines a DR4-presented T cell epitope that is shared among the E7 genes of HPV59 and HPV68. MHC class II-presented peptides may be implemented to augment T cell responses directed against autologous tumor cells, particularly if cancer cells lack MHC class I expression, which is a frequent event in the evolution of cervical cancer.     

Wogonin induces apoptosis by suppressing E6 and E7 expressions and activating intrinsic signaling pathways in HPV-16 cervical cancer cells

Wogonin is a flavonoid compound extracted from Scutellaria baicalensis and is well known as a benzodiazepine receptor ligand with anxiolytic effects. Many recent studies have demonstrated that wogonin modulates angiogenesis, proliferation, invasion, and tumor progress in various cancer tissues. We further explored the mechanism of action of wogonin on cervical cancer cells that contain or lack human papillomavirus (HPV) DNA. Wogonin was cytotoxic to HPV 16 (+) cervical cancer cells, SiHa and CaSki, but not to HPV-negative cells. We demonstrated that wogonin induced apoptosis by suppressing the expressions of the E6 and E7 viral oncogenes in HPV-infected cervical cancer CaSki and SiHa cells. The modulation of p53 and protein retinoblastoma (pRb) were also triggered by the suppression of E6 and E7 expressions. However, p53 was not altered in HPV-negative cervical cancer C33A cells. Moreover, wogonin modulated the mitochondrial membrane potential and the expression of pro- and anti-apoptotic factors such as Bax and Bcl-2. Wogonin also provoked the cleavage of caspase-3, caspase-9, and poly ADP ribose polymerase. After transfection of siRNAs to target E6 and E7, additional restoration of p53 and pRb was not induced, but processing of caspases and PARP was increased compared with wogonin treatment alone. Together, our findings demonstrated that wogonin effectively promotes apoptosis by downregulating E6 and E7 expressions and promoting intrinsic apoptosis in human cervical cancer cells.     

高危型人乳头瘤病毒感染与宫颈癌中miR-218表达的关系

目的观察高危型人乳头瘤病毒(HPV)感染与宫颈癌中miR-218表达的关系。方法收集2015年6月至2018年12月我院手术切除的宫颈癌组织并检测高危型HPV感染情况和miR-218表达量。培养HPV16阳性的SiHa细胞株并进行分组,阴性对照(NC)组转染NC模拟物、miR-218组转染miR-218模拟物,检测两组细胞凋亡率、B淋巴细胞瘤-2基因(Bcl-2)、Bcl-2相关x蛋白(Bax)、Bcl-2相互作用细胞死亡介导因子(Bim)、含半胱氨酸的天冬氨酸蛋白水解酶(Caspase)-9、Caspase-3的mRNA表达量及凋亡通路分子c-Jun氨基末端激酶(JNK)、c-Jun基因(c-Jun)、磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B(AKT)、哺乳动物雷帕霉素靶蛋白(mTOR)的蛋白表达量。结果高危型HPV阳性的宫颈癌组织中miR-218表达量减少。转染24 h后,miR-218组细胞凋亡率、细胞中Bax、Bim、Caspase-9、Caspase-3的mRNA表达量及JNK、c-Jun的蛋白表达量均明显高于NC组,而细胞中Bcl-2的mRNA表达量及PI3K、AKT、mTOR的蛋白表达量均低于NC组,差异均有统计学意义(均P<0.05)。结论miR-218在高危型HPV感染的宫颈癌组织中表达减少。增加miR-218的表达能够促进HPV感染宫颈癌细胞的凋亡。该调控作用与JNK/c-Jun通路的激活及PI3K/AKT/mTOR通路的抑制有关。     

The High-Risk HPV16 E7 Oncoprotein Mediates Interaction between the Transcriptional Coactivator CBP and the Retinoblastoma Protein pRb

The oncoprotein E7 from human papillomavirus (HPV) strains that confer high cancer risk mediates cell transformation by deregulating host cellular processes and activating viral gene expression through recruitment of cellular proteins such as the retinoblastoma protein (pRb) and the cyclic-AMP response element binding binding protein (CBP) and its paralog p300. Here we show that the intrinsically disordered N-terminal region of E7 from high-risk HPV16 binds the TAZ2 domain of CBP with greater affinity than E7 from low-risk HPV6b. HPV E7 and the tumor suppressor p53 compete for binding to TAZ2. The TAZ2 binding site in E7 overlaps the LxCxE motif that is crucial for interaction with pRb. While TAZ2 and pRb compete for binding to a monomeric E7 polypeptide, the full-length E7 dimer mediates an interaction between TAZ2 and pRb by promoting formation of a ternary complex. Cell-based assays show that expression of full-length HPV16 E7 promotes increased pRb acetylation and that this response depends both on the presence of CBP/p300 and on the ability of E7 to form a dimer. These observations suggest a model for the oncogenic effect of high-risk HPV16 E7. The disordered region of one E7 molecule in the homodimer interacts with the pocket domain of pRb, while the same region of the other E7 molecule binds the TAZ2 domain of CBP/p300. Through its ability to dimerize, E7 recruits CBP/p300 and pRb into a ternary complex, bringing the histone acetyltransferase domain of CBP/p300 into proximity to pRb and promoting acetylation, leading to disruption of cell cycle control.     

Induction of human papillomavirus-specific CD4(+) and CD8(+) lymphocytes by E7-pulsed autologous dendritic cells in patients with human papillomavirus type 16- and 18-positive cervical cancer.

Human papillomavirus (HPV) type 16 (HPV 16) and HPV type 18 (HPV 18) are implicated in the induction and progression of the majority of cervical cancers. Since the E6 and E7 oncoproteins of these viruses are expressed in these lesions, such proteins might be potential tumor-specific targets for immunotherapy. In this report, we demonstrate that recombinant, full-length E7-pulsed autologous dendritic cells (DC) can elicit a specific CD8(+) cytotoxic T-lymphocyte (CTL) response against autologous tumor target cells in three patients with HPV 16- or HPV 18-positive cervical cancer. E7-specific CTL populations expressed strong cytolytic activity against autologous tumor cells, did not lyse autologous concanavalin A-treated lymphoblasts or autologous Epstein-Barr virus-transformed lymphoblastoid cell lines (LCL), and showed low levels of cytotoxicity against natural killer cell-sensitive K562 cells. Cytotoxicity against autologous tumor cells could be significantly blocked by anti-HLA class I (W6/32) and anti-CD11a/LFA-1 antibodies. Phenotypically, all CTL populations were CD3(+)/CD8(+), with variable levels of CD56 expression. CTL induced by E7-pulsed DC were also highly cytotoxic against an allogeneic HLA-A2(+) HPV 16-positive matched cell line (CaSki). In addition, we show that specific lymphoproliferative responses by autologous CD4(+) T cells can also be induced by E7-pulsed autologus DC. E7-specific CD4(+) T cells proliferated in response to E7-pulsed LCL but not unpulsed LCL, and this response could be blocked by anti-HLA class II antibody. Finally, with two-color flow cytometric analysis of intracellular cytokine expression at the single-cell level, a marked Th1-like bias (as determined by the frequency of gamma interferon- and interleukin 4-expressing cells) was observable for both CD8(+) and CD4(+) E7-specific lymphocyte populations. Taken together, these data demonstrate that full-length E7-pulsed DC can induce both E7-specific CD4(+) T-cell proliferative responses and strong CD8(+) CTL responses capable of lysing autologous naturally HPV-infected cancer cells in patients with cervical cancer. These results may have important implications for the treatment of cervical cancer patients with active or adoptive immunotherapy.     

Tetramer技术检测人乳头瘤病毒抗原特异性T细胞条件的优化

人乳头瘤病毒(human papillomavirus,HPV)感染是宫颈癌发生的首要因素。针对病毒早期蛋白E6的特异性细胞毒性T淋巴细胞(cytotoxic Tlymphocyte,CTL)在清除HPV感染细胞和病毒转化形成的肿瘤细胞过程中发挥重要作用,因此检测体内抗原特异性CTL的频数和功能有助于了解病毒感染者或宫颈癌患者体内的特异性细胞免疫反应。利用加载HPV16 E6表位抗原肽(E6 133-142;HNIRGRWTGR)的HLA-A6801四聚体(Tetramer),即HPV16 E6 133-142/HLA-A6801-PE四聚体,通过检测混有HPV特异性CTL的PBMC标本,优化Tetramer染色的实验条件,探讨染色的最佳温度及Tetramer浓度。结果显示,染色温度(4℃、室温及37℃)对Tetramer与CTL的结合无明显影响。Tetramer稀释度为1∶1 600时,HPV特异性CTL荧光强度保持高水平,且非特异性染色少,为最佳染色浓度。研究结果为进一步检测HPV感染者或宫颈癌患者体内抗原特异性的CTL打下基础。     

1235例妇科门诊患者高危型HPV感染状况及亚型分布调查研究

目的了解本地区妇科门诊患者宫颈高危型HPV感染状况及亚型分布,为今后的宫颈癌前病变、宫颈癌防治提供临床依据。方法采用基因芯片技术对1 235例妇科门诊患者进行HPV筛查,筛查出的阳性患者应用流式荧光杂交法进行高危型HPV亚型检测,分析比较宫颈炎、宫颈鳞癌及宫颈腺癌患者高危型HPV感染情况及亚型分布差异。结果六安市金安区妇幼保健院妇科门诊患者HPV感染率高达60%,其中高危型HPV感染率为43. 2%,主要以HPV16、HPV18为主;低危型HPV感染率为30.0%,主要以HPV11为主;单一感染阳性率为34. 1%,而混合型感染高达65. 9%,且两者均以HPV16型和HPV18型为主。宫颈炎患者HPV16型、HPV18型及HPV16 ＋ HPV18型的检出率明显低于宫颈鳞癌和宫颈腺癌患者,其中宫颈腺癌患者HPV16 ＋ HPV18型混合感染率最高。结论妇科门诊患者HPV感染率较高,宫颈癌患者HPV16及18型检出率显著高于宫颈炎患者,加强HPV高危基因型的监测有助于预警宫颈癌尤其是宫颈腺癌的发生。     

Design,Immune Responses and Anti-Tumor Potential of an HPV16 E6E7 Multi-Epitope Vaccine

Cervical cancer is a common type of cancer among women worldwide and infection with high-risk human papillomavirus (HPVs) types represents the major risk factor for the etiopathogenesis of the disease. HPV-16 is the most frequently identified HPV type in cervical lesions and expression of E6 and E7 oncoproteins is required for the uncontrolled cellular proliferation. In the present study we report the design and experimental testing of a recombinant multi-epitope protein containing immunogenic epitopes of HPV-16 E6 and E7. Tumor preventive assays, based on the engraftment of TC-1 cells in mice, showed that the E6E7 multi-epitope protein induced a full preventive anti-tumor protection in wild-type mice, as well as in mice deficient in expression of CD4⁺ T cells and TLR4 receptor. Nonetheless, no anti-tumor protection was observed in mice deficient in CD8⁺ T cells. Also, the vaccine promoted high activation of E6/E7-specific T cells and in a therapeutic-approach, E6E7 protein conferred full anti-tumor protection in mice. These results show a potential use of this E6E7 multi-epitope antigen as a new and promising antigen for the development of a therapeutic vaccine against tumors induced by HPV.     

宫颈癌患者人乳头瘤病毒(HPV)主要型别及其感染研究

本文探讨了江西省和广东省宫颈癌患者人乳头瘤病毒(Human papillomavirus,HPV)感染及其型别分布,分析了高危型HPV对各种宫颈病变的感染情况,为宫颈癌的早期发现和临床诊治提供科学依据。首先采用细胞学、HPV DNA检测(第二代杂交捕获法,HC2)、电子阴道镜和宫颈化学着色方法筛查宫颈癌患者,经病理镜检确诊,然后用GP PCR-SBT法对宫颈癌患者进行HPV基因分型。江西省溪口镇、古市镇及修水县城宫颈癌癌前病变发生率为5．7‰。HC2方法发现宫颈癌患者13种高危型HPV DNA阳性率为89．9％,宫颈上皮内瘤样病变的为84．8％,对照组为24．5％。采用GP PCR-SBT方法进行基因分型发现,江西省宫颈癌患者存在HPV16、58、31、33、18、66、6、11、56和81十种型别,其中HPV81型在国内外鲜有报道。据此提出生殖道高危型HPV感染是妇女宫颈癌发病的重要因素。并发现江西省宫颈癌高发区妇女高危型HPV感染率为24．5％。建立了HPV基因分型的方法,对HPV致宫颈病变的分子机制进行了分析。