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目的调查陇南市武都区农村妇女人乳头瘤病毒(human papilloma virus,HPV)感染、宫颈上皮内瘤变(cervical intraepithelial neoplasm grade,CIN)与P16~(INK4A)表达情况,并分析其相关性。方法采用整群抽样的方法抽取武都区两个乡镇符合入选条件并愿意接受检查的农村妇女2 052人进行宫颈癌筛查,对病理学结果异常者145例进行P16~(INK4A)检测。结果武都妇女宫颈异常者中HPV感染与P16~(INK4A)阳性的关联强度的OR值为31.28(10.323,94.785);P16~(INK4A)表达阳性率在各组织学类型中的表达差异有统计学意义(P<0.001),P16~(INK4A)表达阳性与组织学类型有相关性(r=0.56,P<0.001)。以HPV检测结果为金标准,P16~(INK4A)检测样本的灵敏度为60.53%,特异度为95.33%,阳性预测值为82.14%,阴性预测值为87.18%。结论 CIN病变组织中HPV感染与P16~(INK4A)阳性之间有关联;随着病变程度的增加,P16~(INK4A)蛋白的表达逐步增加。
Objective To investigate the infection of human papilloma virus (HPV), cervical intraepithelial neoplasm grade (CIN) and P16 INK4A in rural women in Wudu District of Longnan City, and analyze their correlation. Methods A total of 2 052 rural women who met the inclusion criteria and were willing to be examined were enrolled in the study. The cervical cancer was screened by cluster sampling method and P16 INK4A was detected in 145 cases with pathological abnormalities. Results The OR value of the association strength between HPV infection and P16 INK4A positive in Wudu women with cervical abnormality was 31.28 (10.323,94.785). The positive expression rate of P16 INK4A in each group of histological types was statistically significant (P <0.001). The positive expression of P16 INK4A was correlated with the histological type (r = 0.56, P <0.001). The HPV test results as the gold standard, P16 ~ (INK4A) test sample sensitivity was 60.53%, specificity was 95.33%, positive predictive value was 82.14%, negative predictive value was 87.18%. Conclusions There is a correlation between HPV infection and P16 INK4A positive in CIN lesion. The expression of P16 INK4A protein gradually increases with the increase of lesion degree.