人乳头瘤病毒16型<i>E</i>5基因在宫颈癌发生进程中的动态研究

李茂圆; 简洁; 梁开如; 喻景瑞; 李明; 唐凤祝; 李婉宜

人乳头瘤病毒16型E5基因在宫颈癌发生进程中的动态研究

Study on Dynamic Changes of Human Papillomavirus 16 E5 Gene in the Occurrence of Cervical Cancer

摘要

摘要:
目的观察人乳头瘤病毒(HPV)16型E5基因在宫颈癌发生发展过程中的动态变化情况，探讨E5 mRNA在宫颈癌早期筛查中的临床意义。
方法收集2015年9月至2017年12月在四川省妇幼保健院宫颈门诊就诊或行宫颈癌机会性筛查人群的宫颈病变组织石蜡标本49例(HPV阳性)，按照FIGO标准将收集的宫颈病变标本进行分期：宫颈炎13例，宫颈上皮内瘤样病变(CIN)Ⅰ 5例，CIN Ⅱ 18例，CIN Ⅲ 5例，宫颈癌8例。利用实时荧光定量PCR检测不同病理分级宫颈组织中E5基因的完整度及E5、E6、E7 mRNA的表达水平。
结果在49例HPV16阳性感染患者中，CINⅠ宫颈病变组织中E5基因的完整度比宫颈炎、CINⅡ及宫颈癌组织更高(P＜0.05)；CINⅠ宫颈病变组织中E5基因完整度虽高于CINⅢ组织，但差异无统计学意义。不同病理级别标本中E5、E6、E7 mRNA的表达水平均在CINⅢ组织最高。与E6、E7 mRNA相比，E5 mRNA在宫颈病变的全过程中均呈现出优势表达状态(P＜0.05)，而E6、E7 mRNA的表达水平只在病变后期(CINⅢ和宫颈癌)有升高趋势。
结论在HPV16阳性感染患者的病变组织中，E5基因的完整度可能与宫颈疾病的发生、发展有关。E5基因有望成为宫颈癌早期筛查的靶基因。

Abstract:
Objective To explore the dynamic changes of human papillomavirus (HPV) type 16 E5 gene in the development of cervical cancer and the significance of E5 mRNA in early screening of cervical cancer.
Methods Paraffin specimens of cervical lesions were collected from 49 cases (HPV positive) during September 2015 to December 2017 According to the standard of FIGO, all cervical lesions were diagnosed as: 13 cases of cervicitis, cervical intraepithelial neoplasia disorders (CIN) Ⅰ in 5 cases, CIN Ⅱ in 18 cases, CIN Ⅲ in 5 cases, 8 cases of cervical cancer. Real-time fluorescence quantitative PCR was used to detect the integrity of E5 gene and the mRNA expression levels of E5, E6 and E 7in cervical tissues.
Results All the 49 cases showed positive HPV16 infection. E5 genetic integrity in CINⅠwas higher than that in cervical inflammation, CIN Ⅱand cervical cancer (P < 0.05), which was also higher than that in CIN Ⅲ, but without statistically significance (P>0.05). The mRNA levels of E5, E6, E7 were the highest in CIN Ⅲ. Compared with E6 and E7, E5 presented superior expression in all types of cervical lesions (P < 0.05), while E 6and E7 mRNA expressions only increased in CIN Ⅲ and cervical cancer.
Conclusion In the patients with HPV16 infection, the integrity of E5 gene in cervical tissues may be related to the occurrence and development of cervical diseases. E5 gene is expected to be the target gene for early screening of cervical cancer.

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