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目的 探讨人乳头瘤病毒(HPV)在外阴HPV相关疾病—尖锐湿疣(CA)、外阴上皮内瘤变(VIN)和外阴鳞状细胞癌(VSCC)中的感染情况及与p53,cyclinD1,ki67蛋白表达的关系。方法 在110例外阴HPV相关疾病中应用核酸分子快速导流杂交基因分型技术检测HPV16/18,HPV6/11的表达,同时用免疫组化SP法检测p53,cyclinD1,ki67蛋白的表达,并与10例正常组织进行对照。结果 HPV16/18在CA组,VIN组及VSCC组的阳性表达率均高于正常对照组,而且其阳性表达率随外阴上皮恶性程度增加而增加;HPV6/11在CA组及VINⅠ组的阳性表达率均高于VINⅡ组及VINⅢ组和正常对照组;以上差异均有统计学意义(P均<0.05)。HPV6/11在VSCC组无阳性表达,HPV16/18感染与p53,ki67表达呈正相关,与cyclinD1表达无相关性。HPV6/11感染与p53,cyclinD1,ki67表达无相关性。结论 HPV16/18感染与重度外阴上皮内瘤变及外阴鳞状细胞癌密切相关;HPV6/11感染是尖锐湿疣及轻度外阴上皮内瘤变的重要病因。HPV16/18感染与p53,ki67蛋白表达呈正相关,它们在外阴鳞状上皮恶变过程中有着协同的作用。
Objective To investigate the infection of human papillomavirus (HPV) in vulvar HPV-related diseases including condyloma acuminata (CA), vulvar intraepithelial neoplasia (VIN) and vulvar squamous cell carcinoma (VSCC) The relationship between expression. Methods The expression of HPV16 / 18 and HPV6 / 11 was detected by rapid flow-through hybridization (PCR) in 110 cases of vulvar HPV-related diseases. The expressions of p53, cyclinD1 and ki67 were detected by immunohistochemical SP method 10 cases of normal control. Results The positive rates of HPV16 / 18 in CA group, VIN group and VSCC group were higher than those in normal control group, and the positive expression rate of HPV16 / 18 increased with the malignant degree of vulvar epithelium. The positive expression of HPV6 / 11 in CA group and VINⅠ group The rates were higher than those in VINⅡ group and VINⅢ group and the normal control group. The above differences were statistically significant (all P <0.05). There was no positive expression of HPV6 / 11 in VSCC group, HPV16 / 18 infection was positively correlated with the expression of p53 and ki67, but not with the expression of cyclinD1. HPV6 / 11 infection and p53, cyclinD1, ki67 expression no correlation. Conclusion HPV16 / 18 infection is closely related to severe vulvar intraepithelial neoplasia and vulvar squamous cell carcinoma. HPV6 / 11 infection is an important cause of condyloma acuminatum and mild vulvar intraepithelial neoplasia. HPV16 / 18 infection and p53, ki67 protein expression was positively correlated, they have a synergistic effect in the vulvar squamous cell malignant transformation process.