Human Papillomavirus And Cervical Neoplasia Occurrence And Development

OBJECTIVES1.To investigate whether it is possible to use detection of the human papillomavirus (HPV) L1 capsid protein to predict the course of mild or moderate cervical intraepithelial neoplasia(CIN).2.To explore the expressions of 14-3-3σ,hWAPL and HIF-1αmRNA in cervical cancer and CINs。To analyze the role they play in the progression of CIN_s.3.To observe the relation between cervical neoplasia and the viral load aquired by HCII. To assess the value of HC-Ⅱfor follow up after conization.METHODS1.Imrnunocytochemical analysis using antibody against HPV L1 capsid protein was carried out on 274 cases of TRIPATH Pap tests with abnormal cytologic diagnoses and positive for high-risk HPV DNA detected by HC-Ⅱ.2.Collect fresh tissues from cervix.Extract total RNA and evaluate the relative expressions of 14-3-3σ,hWAPL and HIF-1αmRNA with real-time fluorogenetic quantitative PCR(RFQ-PCR).3.A total of 2830 women were screened for cervical lesion.We assessed the relations between CINs and the viral load aquired by HC-Ⅱ.4.648 patients accepted conization for≥CIN II histologically.We analyzed the changes of HC-Ⅱresults and the recurrences of lesions.RESULTS1.Cytologic diagnosis revealed a higher expression of L1 protein in LSIL(75.63%, 90/119)than in ASC-US(63.81%,67/105)and in HSIL/SCC(4/41,9.76%)(P<0.01).2.71 cases without treatment accepted LCT test after lyear.In the cases expressing L1, 80%(44/55) regressed to NILM,and no one progressed.In the cases not expressing L1,only 37.50%(6/16) regressed to NILM,and 18.75%(3/16) progressed to ASC-H and HSIL.3.The average quantity of 14-3-3σmRNA in cervical caner tissues was significantly higher than that in cervicitis tissues(t-test,P<0.05).4.The average quantity of hWAPL mRNA in cervical caner and CINs tissues was significantly higher than that in cervicitis tissues(t-test,P<0.05).5.The viral loads of high-risk HPV DNA in invasive cervical cancer and CINs were similar.6.After conization,20.62%of the patients with positive surgical margins got persistent/recurrent lesions,while only 1.63%of those with negative surgical margins did.No persistent/recurrent lesions happened on the patients with persistent negative results of HC-Ⅱ.While 25%of those with persistent positive results of HC-Ⅱdid.CONCLUSIONS1.The expression of HPV L1 in LSIL was significantly higher than in HSIL.The disease may progress while not expressing L1 protein or non-expressing persistently.2.14-3-3σand hWAPL may play an role in the emergence of cervical cancer.3.The viral load of high-risk HPV DNA has no relation with the severity of cervical lesions.HC-Ⅱhas great significance for the follow-up after conization.