| Background and ObjectiveUterine cervical lesion, one of the most common female diseases, is likely to deteriorate into cervical cancer at the worst. The incidence of cervical cancer has reached the second place among female malignant tumors, just following the breast cancer, and even up to top in some developing countries. At present, it is generally accepted that the main mechanism of causing uterine cervical cancer is that persistent infection of the high risk human papillomavirus (HR-HPV-DNA), the decline of their immune function and the cervical microenvironment change elements, have HPV-DNA integrated into the host chromosome to express the cancer gene of E6, E7that, with the coordination of other carcinogens (such as prolific, disorder, smoking), inhibits the function of tumor suppressor gene like p53, Rb, activates the telomerase (hTERC), prevents cells from decaying and escapes from the normal immune surveillance, ultimately, which leads to cell cycle control and has the cells immortalize into cancerous ones. This paper is aimed to analyze and summarize the expression of human papillomavirus Ll capsid protein (HPV Ll) and human telomerase RNA component gene (hTERC) in different pathological tissues of the uterine cervix, and to explore the human papillomavirus L1capsid protein and human telomerase RNA component as diagnosis of uterine cervical lesion, and to further assess the application value of progress risk indexes.Object and methods1.Objects:To collect and summarize the medical record of1635cases of married women with cervical lesion of the Department Gynecology of the Second Affiliated Hospital of Zhengzhou University from September2010to December2011, and, at the same time, to detect thinprep cytologic(TCT) and human papillomavirus(HPV). The patients are aged between20and65, with the average of40.6±0.4.2.Methods:To have histopathological examined under colposcopy of patients with one or two abnormal of TCT or HPV; to apply the immunohistochemical method to examine the HPV Ll capsid protein expression of the559patients with HPV positive and TCT normal; to apply fluorescent in situ hybridization(FISH) method to examine the hTERC gene amplification of the75cases out of139patients with TCT and HPV abnormal; finally, to compare the results with that of histopathology respectively.3. Statistics:SPSS17.0software will be used to analyze the data. According to the data, chi-square or nonparametric Kruskal-Wallis H test (to use Fisher’s exact probability for those that do not satisfy the condition) will be applied with a=0.05for the inspection level.Resultsl.The expression of Ll capsid protein in different HPV category:among1635patients in this research,559cases are examined with HPV positive and TCT normal, accounting for34.2%of total number, specifically,161cases with the low risk (LR-HPV) positive,187cases with mixed positive, and211cases with high risk (HR-HPV) positive. The positive expression rate of HPV Ll capsid protein is:96.27%(155/161)in LR-HPV (+),85.03%(159/187)in mixed HPV (+) and59.72%(126/211) in HR-HPV (+) respectively. The positive expression rate of HPV Ll capsid protein in the three groups has statistical significance(X2=79.523, P<0.001). After two-two comparison it is further concluded that:Ll capsid protein positive expression rate of LR-HPV (+) group is significantly higher than that of the mixed HPV (+) group (X2=12.413, P<0.001)and HR-HPV(+)group(x2=66.048, P±0.001), and that the expression rate of L1capsid protein of the mixed HPV (+) group and the HR-HPV(+)group also has statistical significance.2. The expression of L1capsid protein in different pathological tissues:the histopathology result of biopsy of559cases with HPV positive and TCT normal patients under colposcopy is:384cases with the normal/inflammation;73cases with CIN Ⅰ;58cases with CINⅡ;40cases with CIN Ⅲ and4cases with cervical squamous cell carcinoma (SCC). The positive expression rate of HPV L1capsid protein in groups of the normal/inflammation, CIN Ⅰ, CIN Ⅱ, CINⅢ and SCC is77.86%(299/384),68.49%(50/73),18.97%(11/58),7.50%(3/40),0respectively. The positive expression rate of L1capsid protein has statistical significance with an overall comparison among the five groups(H=147.527, P＜0.001). After two-two comparison it is further concluded that:the comparison between normal/inflammation and CINⅡ, CINⅢ, SCC group has statistical significance(χ2=87.818, P＜0.001;χ2=13.069, P＜0.001;χ2=9.530, P=0.002<0.005); the comparison between CIN Ⅰ and CIN Ⅱ, CINⅢ, SCC group also has statistical significance(χ2=31.863, P＜0.001;χ2=38.601, P＜0.001;χ2=5.095,P=0.004<0.005); there is not statistical significance in other two-two comparison.3. The expression of hTERC gene in the different cervical lesion tissues:among1635patients in this research,139cases have been examined with HPV and TCT abnormal, accounting for8.50%of total number. The result of applying the fluorescent in situ hybridization(FISH) method to detect the hTERC gene amplification of75patients is:18cases with normal/inflammation,19cases with CIN Ⅰ,16cases with CINⅡ,14cases with CIN Ⅲ,8cases with cervical squamous cell carcinoma (SCC). The positive expression rate of hTERC gene in groups of the normal/inflammation, CIN Ⅰ, CIN Ⅱ, CINⅢ, and SCCgroup is5.56%(1/18),21.05%(4/19),50%(8/16),85.71%(12/14),100%(8/8)respectively. The positive amplification rate of hTERC gene has statistical significance with an overall comparison among the five groups(H=34.691,P＜0.001). After two-two comparison it is further concluded that:the comparison between normal/inflammation and CINⅢ, SCC group has statistical significance (χ2=17.786,P＜0.001;χ2=17.854,P＜0.001); the comparison between CIN Ⅰ and CINⅢ,SCC group has statistical significance (X2=11.029, P=0.001<0.005; X2=11.193, P=0.001<0.005); there is not statistical significance in other two-two comparison.Conclusions1. The positive expression rate of HPV L1capsid protein is gradually decreasing in order of low risk, mixing, high risk HPV (+).2. The positive expression rate of HPVL1capsid protein is gradually decreasing with cervical histopathological progressing.3. The positive amplification rate of hTERC is gradually increasing with cervical histopathological progressing.4. Human papillomavirus Ll capsid protein and human telomerase RNA component can clinically be used as diagnosis of uterine cervical lesion and as an effective index to further assess the progress risk. |
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