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[目的]评价高危型人乳头状瘤病毒HPV负荷量的检测和p16INK4A蛋白的表达在预测宫颈上皮内瘤变(CIN)宫颈锥切术后残存病变或复发中的意义。[方法]回顾性分析142例2008年10月至2010年12月因CIN行宫颈锥形切除术治疗患者的临床资料。所有患者均于宫颈锥形切除术前6个月以内和术后6～12个月进行HPV负荷量检测,并采用免疫组化方法检测HPVDNA阳性患者宫颈细胞中p16INK4A蛋白表达。[结果]宫颈锥切术前,随着CIN级别的上升,HPV负荷量以及p16INK4A蛋白表达均明显增强(P<0.05)。但在宫颈锥切术后,HPV负荷量和p16INK4A蛋白表达明显降低,宫颈锥切术前和术后两者之间差异有统计学意义(P<0.05)。[结论]HPV负荷量持续增高和p16INK4A蛋白持续呈强阳性是宫颈锥切术后发生残存病变或复发的高危因素,在监测HPV负荷量的同时检测p16INK4A蛋白的表达,对判断宫颈锥切术后发生残存病变或复发有重要意义。
[Objective] To evaluate the detection of high-risk human papilloma virus HPV load and the expression of p16INK4A protein in predicting the residual lesion or recurrence of cervical intraepithelial neoplasia (CIN) after cervical conization. [Methods] A retrospective analysis of 142 patients from October 2008 to December 2010 CIN cervical taper resection in patients with clinical data. All patients were tested for HPV load within 6 months before and after 6 to 12 months of cervical conization, and p16INK4A protein expression was detected by immunohistochemistry in cervical cells with HPVDNA positive. [Results] Before cervical conization, HPV load and p16INK4A protein expression were significantly increased with the increase of CIN level (P <0.05). However, after cervical conization, HPV load and p16INK4A protein expression decreased significantly, cervical conization before and after surgery there was a significant difference between the two (P <0.05). [Conclusion] The continuous increase of HPV load and the persistent positive expression of p16INK4A protein are the risk factors of residual disease or recurrence after cervical conization, and the expression of p16INK4A protein is detected while monitoring HPV load. Residual disease or recurrence of great significance.