HPV检测联合人髓细胞增生原癌基因检测对宫颈癌前病变筛查的临床价值

摘要 目的：探讨人乳头状瘤病毒（HPV）检测联合人髓细胞增生原癌基因（C-MYC）检测对宫颈癌前病变-宫颈上皮内瘤变（CIN）筛查的临床价值。方法：选择2018年6月至2020年12月在本院妇科保存的宫颈上皮内瘤变标本140份，采用免疫组化法检测C-MYC表达情况，采用PCR检测HPV16、HPV18表达情况并进行相关性分析。结果：在140份标本中，HPV16与HPV18的阳性率为62.9 %与61.4 %；CIN 1级标本HPV16、HPV18阳性率分别为26.8 %和24.4 %，2级标本分别为62.7 %和58.8 %，3级标本分别为93.8 %和95.8 %，对比有差异（P<0.05）。C-MYC阳性率为83.6 %，不同CIN分级程度的标本组织中C-MYC阳性率对比有差异（P<0.05）。Spearsman相关分析显示HPV16、HPV18、C-MYC阳性率与CIN分级呈相关性（P<0.05）。二分类Logisitc回归分析显示HPV16、HPV18、C-MYC阳性率都为影响CIN分级的重要危险因素（P<0.05）。结论：随着宫颈上皮内瘤变级别的增加，HPV16、HPV18的阳性率也在升高，同时伴随C-MYC的过表达，两者具有相关性，是导致患者病情加重的重要危险因素。

The Clinical Value of HPV Detection Combined with Human Myeloid Hyperplasia Proto-oncogene Detection in the Screening of Cervical Precancerous Lesions

ABSTRACT Objective: To explore the clinical values of human papillomavirus (HPV) detection combined with human myelocytomatosis oncogene (C-MYC) detection in the screening of cervical precancerous lesions-cervical intraepithelial neoplasia (CIN). Methods: A total of 140 specimens of cervical squamous intraepithelial lesions were selected from the department of our hospital from June 2018 to December 2020, the expression of C-MYC were detected by immunohistochemistry, the expression of HPV16, HPV18 were detected by PCR and given correlation analysis. Results: In the 140 specimens, the positive rates of HPV16 and HPV18 were 62.9 %, 61.4 %; the positive rates of HPV16 and HPV18 were 26.8 %, 24.4 % in CIN level 1 specimens, and 62.7 %, 58.8 % in level 2 specimens, and 93.8 %, 95.8 % in level 3 specimens, respectively, and compared the difference were statistically significant(P<0.05). The positive rates of C-MYC were 83.6 %; with the increase in the degree of CIN classification, the positive rates of C-MYC in the specimen tissue were also increased, and compared the difference were statistically significant(P<0.05). Spearsman correlation analysis showed that the positive rates of HPV16, HPV18, C-MYC were all correlated with CIN level(P<0.05). Binary Logisitc regression analysis showed that the positive rates of HPV16, HPV18, C-MYC were all important risk factors affect CIN level(P<0.05). Conclusion: With the increase of the grade of cervical intraepithelial neoplasia, the positive rate of HPV16 and HPV18 also increased, accompanied by the overexpression of C-MyC, which were correlated and were important risk factors leading to the aggravation of patients'' disease.