HPV L1Capsid Protein Expression In Squamous Intraepithelial Lesions Of Cervix Uteri And Its Significance

BackgroundCervical cancer is the second most common malignancy in a threat to the health and lives of women. It has been confirmed that the sustained infection of human papilloma virus (HPV) is a necessary factor for cervical cancer. HPV DNA detection combined with cervical cytology detection has been used for early screening for cervical cancer in clinical work, and greatly reduces the incidence of cervical cancer. However, the lack of markers to predict the biological behavior of cervical lesions make the clinical doctors give more excessive or unnecessary treatment in the treatment of cervical lesions, which not only endanger the patient’s health, while also increasing the economic and emotional burden. The capsid protein of HPV L1protein accounts for about90%of capsid protein,which is the main target attacked by the human immune response to HPV virus. The rate of the expression of HPV L1capsid protein decreases gradually with the progress of cervical lesions. HPV L1capsid protein is the current research focus.ObjectiveThe aims of the study is to detect the expression of HPV L1capsid protein in the different levels of cervical lesions and to study the relation between HPV L1capsid protein,HPV16/18infection,age,cervical lesions in order to explore the clinical value of HPV L1protein.MethodSelect496womens,who are detected HPV infection by using the Hybrid Capture (or diversion hybrid) and performed Liquid-based cytology (TCT) and histopathology in the department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University from October2011to March2013. For cytological diagnosed,there were NILM279cases,51cases of ASC-US, LSIL77cases, ASC-H23cases, HSIL66cases. For histopathological diagnosed, there were CC(Chronic Cervicitis)282cases,CINl93cases,CIN222cases,CIN383cases,Squamous cell carcinoma16cases. Immunocytochemical analysis using antibody against HPV LI capsid protein was carried out on Liquid-based cytology (TCT) and biopsy. Analyzed the relation of HPV subtypes, age, HPV L1protein, cytology and histopathology results by using the SPSS statistical package program17.0through a separate analysis, control analysis, chi-square test. The correlation analysis was analyzed by pearson correlation test. Significant level is a=0.05,and P<0.05is considered statistically significant. Result1. Of the496cases,the average positive rates of HPV L1capsid protein in cervical lesions were22.6%(112/496).HPV L1capsid protein was positive in21.99%(62/282) of Chronic Cervicitis,34.41%(32/93) of CIN1,27.27%(6/22) of CIN2,13.25%(11/83) of CIN3,6.25%(1/16) of SCC.Analyze the difference of CC group、 CIN1group、CIN2/CIN3group and SCC group,and find out that it was statistically significances (χ2=12.34,P<0.01).The positive rate of HPV L1capsid protein in CIN1group was higher than the CC group (x2=5.746, P<0.05), CIN2/CIN3group (χ2=8.79, P<0.05), SCC group (χ2=5.12, P<0.05).2. HPV L1capsid protein was positive in22.58%(63/279) of NILM,17,65%(9/51) of ASC-US,17.39%(4/23)of ASC-H,35.06%(22/77)of LSIL,13.64%(9/66) of HSIL. Analyze the difference of NILM group、LISL group、ASC-H/HSIL group and ASC-US group,and find out that it was statistically significances (χ2=10.81, P<0.05). The positive rate of HPV L1capsid protein in LISL group was higher than NILM group (χ2=4.98, P<0.05), the ASC-US group (χ2=4.60, P<0.05), ASC-H/HSIL group (χ2=9.48, P<0.05).3. Arrange CIN2and above as the case group and the CC and CIN1lesions as a control group. Stratified by age,we found that in the case group, the positive rate of HPV LI capsid protein in "age>40years old" group was lower than "age≤40years old" group (χ2=4.023, P<0.05); in the control group,there was no significant difference between "age≤40years old" group and "age>40years old" group (χ2=0.022, P>0.05).4. Subtypes of HPV DNA of155patients were tested, and we found that16/18HPV infection of the HPV L1capsid protein-negative group was significantly higher than that of the HPV L1capsid protein positive group (χ2=16.1, P<0.01). The expression of HPV L1protein and HPV16/18infection was a negative correlation (r=-0.322).Conclusion1. The positive rate of HPV L1capsid protein decreased gradually with the progress of cervical lesions.HPV L1capsid protein is expected to be the markers of the biological behavior of the prediction of cervical precancerous lesions.2. The positive rate of HPV L1capsid protein in HPV16/18infected patients was lower than other subtypes of HPV infection.HPV L1protein expression with different HPV subtypes have a certain relation.3. The positive rate of HPV L1capsid protein in CIN2and above had certain relation with age.