首页|HPV L1壳蛋白及p16蛋白在高危型HPV持续感染的宫颈低级别鳞状上皮内病变患者临床转归中的意义

HPV L1壳蛋白及p16蛋白在高危型HPV持续感染的宫颈低级别鳞状上皮内病变患者临床转归中的意义

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目的 探讨人乳头瘤病毒(human papilloma virus,HPV)L1 壳蛋白及p16 蛋白在高危型HPV持续感染的宫颈低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)患者临床转归中的意义.方法 选取 2022 年 1 月至7月在中山市博爱医院妇科宫颈病变中心就诊的114例高危型HPV持续感染且病理确诊为LSIL患者的宫颈组织进行HPV L1、p16 免疫组化分析及随访.结果 114 例LSIL患者累计进展率 21.93%,HPV L1、p16 阳性率分别为 25.44%、39.47%.单独检测中,HPV L1(+)表达者的消退率最高达 68.97%,与进展组、持续组间的差异有统计学意义(P<0.05);联合检测中,HPV L1(+)/p16(+)、HPV L1(+)/p16(-)、HPV L1(-)/p16(+)表达者疾病累计消退率分别为 60.00%、78.57%、43.64%,与累计进展率、持续率的差异均有统计学意义(P<0.05).分层分析发现,单独检测中,HPV L1(+)表达者在第 24 个月时的消退率高于p16(+)表达者,差异有统计学意义(P<0.05).联合检测中,HPV L1(-)/p16(+)表达者在第 6、12 个月时的进展率高于其他患者;而HPV L1(+)/p16(-)表达者在第 24 个月时的消退率高于其他组,差异均有统计学意义(P<0.05).二分类Logistic回归分析结果表明,HPV16/18、p16(+)是LSIL进展的危险因素,OR分别为 3.242(95%CI:1.261~8.336)、2.714(95%CI:1.055~6.980).结论 高危型HPV持续感染型别分析、HPV L1 壳蛋白及p16 蛋白免疫组化检测在高危型HPV持续感染的LSIL患者临床转归中有一定临床价值,有助于指导临床医师对高危型HPV持续感染的LSIL患者进行个体化随访及分流管理.
The significance of HPV L1 capsid protein and p16 protein in the clinical outcomes of cervical low-grade squamous intraepithelial lesion with persistent high-risk HPV infection
Objective To explore the significance of human papilloma virus(HPV)L1 capsid protein and p16 protein in the clinical outcomes of cervical low-grade squamous intraepithelial lesions(LSIL)with persistent high-risk HPV infection.Methods Immunohistochemical analysis of HPV L1 and p16 was conducted on cervical tissues from 114 patients with persistent high-risk HPV infection and pathologically confirmed LSIL who were treated at the Cervical Disease Center of Department of Gynecology,Bo'ai Hospital of Zhongshan from January to July 2022,and follow-up was conducted.Results The cumulative progression rate of 114 LSIL patients was 21.93%,and the positive rates of HPV L1 and p16 were 25.44%and 39.47%,respectively.In the single detection,the regression rate of HPV L1(+)expression was as high as 68.97%,which was significantly different from the progression group and the persistent group(P<0.05);In the combined detection,the cumulative regression rates of HPV L1(+)/p16(+),HPV L1(+)/p16(-),and HPV L1(-)/p16(+),were 60.00%,78.57%,and 43.64%,respectively.There were statistically significant differences in the cumulative progression rate and persistence rate(P<0.05).Stratified analysis revealed that among individuals with HPV L1(+)expression,the regression rate at 24 months was higher than that of individuals with p16(+)expression,with a statistically significant difference(P<0.05).In the combined detection,the progression rate of HPV L1(-)/p16(+)expression in the 6th and 12th months was higher than that of other groups;The regression rate of HPV L1(+)/p16(-)expression in the 24th month was higher than that of other groups,and the differences were statistically significant(P<0.05).The results of the binary Logistic regression analysis indicate that the presence of HPV16/18 and p16 is a risk factor for the progression of LSIL,with OR values of 3.242(95%CI:1.261-8.336)and 2.714(95%CI:1.055-6.980),respectively.Conclusion The analysis of persistent infection types of high-risk HPV,as well as immunohistochemical detection of HPV L1 capsid protein and p16 protein,have certain clinical value in the clinical outcomes of LSIL patients with persistent infection of high-risk HPV,which can help guide clinical physicians to conduct individualized follow-up and triage management of LSIL patients with persistent infection of high-risk HPV.

Cervical low-grade squamous intraepithelial lesionHuman papillomavirusHPV L1 capsid proteinp16 proteinOutcome

罗燕艳、代新珍、廖燕婷、罗小婉、符丽华

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中山市博爱医院妇科,广东中山 528403

中山市博爱医院病理科,广东中山 528403

宫颈低级别鳞状上皮内病变 人乳头瘤病毒 HPV L1壳蛋白 p16蛋白 转归

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(36)