宫颈癌中端粒酶的表达和高危型人乳头瘤病毒感染

目的：研究不同程度子宫颈病变中高危型人乳头瘤病毒HR-HPV感染和端粒酶活性的表达，以探讨两者在宫颈癌及宫颈上皮内瘤变中的作用及相关性。方法：采用第二代杂交捕获技术检测宫颈脱落细胞HPV．DNA含量，并用免疫组织化学EnVision二步法检测宫颈组织标本中端粒酶的表达。结果：（1）端粒酶阳性表达率在对照组、C1NI、CINII、CINⅢ和宫颈癌组分别为10．00％、16．67％、40．00％、70．00％、95．00％，宫颈癌组高于cINⅢ，CINⅢ高于C1NⅡ，C1NII高于CINI，差异均有统计学意5C（X^2=-4．329，P=0．037；xⅫ．327，P=0．038；X^2=4．022，P=0．045）。（2）随着宫颈病变级别的增加，高危型HPV的阳性率和病毒负荷量均增高。高危型HPV的阳性率在宫颈癌和CINⅢ组明显高于对照组、CINI及CINⅡ（X^2=29．501-7．414，P〈0．01）。高危型HPV的病毒负荷量在对照组与其他4组比较，差异均有统计学意K（P〈0．05）；C1NI组分别与CINⅡ、C1NⅢ及宫颈癌组比较差异均有统计学意义（P〈0．05）。（3）随着宫颈病变级别的增加，高危型HPV的阳性率和端粒酶阳性表达率依次递增，两者有明显的相关性（r=0．943，P〈0．01）。结论：高危型HPV感染和端粒酶活性均与宫颈癌前病变及宫颈癌的发生发展密切相关，有望作为子宫颈癌前病变和宫颈癌筛查的监测指标。

Expression of Telomerase and Infection of High Risk Human Papillpmavirus in Cervical Cancer

Objective： To investigate the effect and relationship between high risk human papillomavirus （HR-HPV） infection and telomerase expression in the development of cervical carcinoma. Methods： HPV DNA in cervical exfoliated cells was detected by sec- ond-generation hybird capture technology, then the expression oftelomerase was evaluated by immunohistochemistry. Results： （1） The positive rate oftelomerase in control group, cervical intraepithelial neoplasia（CIN） I group, C1N Ⅱ group, C1NⅢ group and cervical car- cinoma group was 10.00 %, 16.67 %, 40.00 %, 70.00 % and 95.00 %, respectively. The positive rate of telomerase in cervical cancer was significantly higher than that in C1NⅢ （X2=4.329, P=0.037）. And the positive rate in C1NIII was significantly higher than that in CIN II （xZ=4.327, P=-0.038）. And the positive rate in CIN II was significantly higher than that in CIN I （X2=-4.022, P=0.045）. （2） With the de- terioration of carcinoma lesions, HR-HPV load and the positive rate of HPV infection increased gradually. The positive rate of HPV in- fection was significantly different between the cervical cancer group, C1NIII group and CIN II group, CIN I group and control group （X2=-29.501-7.414, P〈0.01）. The high risk HPV load was significantly different between control group and the other groups （P〈0.05）. （3） With the increase of the cervical lesion level, both the high-risk HPV detection rate and the telomerase positive expression rate in- creased, and there was an obvious correlation between the HPV infection and the telomerase expression （r=0.943, P〈0.01）. Conclusion： High-risk type HPV infection and the expression of telomerase had an obvious correlation with the development of cervical intraepithelial neoplasia and cervical cancer, and might be a monitoring index to detect and predict cervical cancer.