HLA-I表达与维吾尔族妇女宫颈癌前病变及HPV16感染的关系研究

目的：观察人白细胞相关抗原I（human leukocyte antigen class I,HLA-I）表达与维吾尔族妇女宫颈癌前病变进程及高危型HPV16的关系。方法：收集维吾尔族妇女宫颈炎、宫颈内上皮瘤样病变（cervical intraepithelial neoplasia,CIN）和宫颈鳞癌患者的石蜡包埋组织标本共148例,提取组织DNA,应用PCR的方法检测HPV阳性及HPV16型别;同时采用免疫组织化学SP法检测HLA-I蛋白表达水平。结果：（1）在维吾尔族妇女中HLA-I抗原在宫颈炎、CINI-II、CINIII、SCC组中阳性表达逐渐减少,差异有统计学意义（P〈0.001）。（2）HLA-I的阳性表达下降趋势与宫颈癌临床分期、组织分化程度和淋巴结转移密切相关。（3）HPV在宫颈炎、CINI-II、CINIII、宫颈癌中的感染率分别为13%、46%、82%、95%,差异有统计学（P〈0.001）。（4）HPV16在宫颈炎、CINI-II、CINIII、宫颈癌中的感染率分别为4%、30%、68%、85%,差异有统计学（P〈0.001）。（5）在HPV16阳性标本中,存在HLA-I表达缺失的占71%（58/82）,HPV16感染与HLA-I表达呈负相关（r=-0.625,P〈0.001）。结论：（1）HLA-I表达缺陷可能是宫颈病变进展的重要标志,对宫颈癌的预测预警提供依据。（2）HPV16感染在宫颈病变的发展过程中起到了极大的促进作用,是一个很强的致癌因素。（3）HPV16感染与HLA-I表达之间的关系对揭示宫颈癌发病机制提供了客观依据。

Association of Expression of Human Leucocyte Antigen Class I with Cervical Precancerous Lesion Pathogenesis in Uighur Women

Objective：To investigate the relationship of the expression of HLA-I （human leucocyte antigen class I） with the cervical precancerous lesion pathogenesis in Uighur women and high risk HPV type 16.Methods：148 cases of formalin fixed and paraffin-embedded cervical tissue specimens were collected from Uighur women with cervicitis, cervical intraepithelial neoplasia （CIN） and cervical squamous cell carcinoma.After abstracting tissue DNA from specimens, PCR （polymerase chain reaction, PCR） technique were used to detect HPV and HPV16, meanwhile the expression of HLA-I were detected by SP assay of immunohistochemistry.Results：The expression of HLA-I gradually reduced in Uighur women with cervicitis, CIN I-II, CIN III,SCC.The difference has statistic meaning （P0.001）.（2）The expression of HLA-I has a close relationship with the clinical staging, the pathology differentiation level and the lymph node metastasis.（3）The infection rate of HPV in cervicitis, CIN I-II, CIN III, cervical squamous cell carcinoma is 13%, 46%, 82%, 95%, respectively.There is statistic difference in this four group （P0.001）.（4） The infection rate of HPV16 in cervicitis, CIN I-II, CIN III, cer-vical squamous cell carcinoma is 4%, 30%, 68%, 85%, respectively.There is statistics difference in this four group （P0.001）.（5）The loss expression of HLA-I accounts 71% in the specimens in HPV16 infected.The infection of HPV16 has negative correlation with the expression of HLA-I.Conclusions：（1） The loss expression of HLA-I may be an important signal of the cervical precancerous change, and has a great application value in the precognition and prewarning of cervical cancer.（2） HPV16 has great promotion effect in the progress of the cervical cancer.It＇s a strong carcinogenesis element.（3） The relation between the infection of HPV16 and the expression of HLA-I has provided an objective evidence to reveal the morbility mechanism of cervical cancer and individualized treatment.