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目的:探讨雌激素受体(ER)及孕激素受体(PR)在不同程度宫颈上皮内瘤病变(CIN)组织中的表达及与人乳头瘤病毒(HPV)的关系。方法:采用免疫组化SP法染色观察ER及PR在160例CIN及正常宫颈组织的表达情况,同时采用PCR方法检测高危型HPV感染。结果:ER在慢性宫颈炎、CINⅠ组、CINⅡ组、CINⅢ组的阳性表达率分别是100.0%、67.9%、40.6%、12.0%;PR在以上各组的阳性表达率分别为29.4%、28.6%、18.8%、1.0%。从慢性宫颈炎到CINⅢ组,ER、PR阳性表达率逐渐降低,ER的表达在各组之间有显著性差异,而PR的表达在各组之间无显著性差异。CIN合并高危型HPV感染的患者行宫颈锥切术后,ER在HPV(+)组阳性表达率为92.9%,在HPV(-)组的表达率为56.7%,两组比较差异有统计学意义。结论:对CIN病变宫颈组织进行ER测定,有助于判断病变的程度,指导治疗。宫颈锥切术后局部ER表达增高,可能促进HPV的增殖,是导致HPV持续感染的重要原因之一。
Objective: To investigate the expression of estrogen receptor (ER) and progesterone receptor (PR) in different degree of cervical intraepithelial neoplasia (CIN) and its relationship with human papillomavirus (HPV). Methods: The expression of ER and PR in 160 cases of CIN and normal cervical tissue was observed by immunohistochemical SP method. Meanwhile, HPV infection in high risk type was detected by PCR. Results: The positive expression rates of ER in chronic cervicitis, CINⅠgroup, CINⅡgroup and CINⅢgroup were 100.0%, 67.9%, 40.6% and 12.0% respectively. The positive rates of PR in the above groups were 29.4% and 28.6% , 18.8%, 1.0%. From chronic cervicitis to CIN Ⅲ group, the positive rate of ER and PR decreased gradually, while the expression of ER had significant difference among the groups, while the expression of PR had no significant difference between the groups. After cervical conization, patients with CIN complicated with high-risk HPV infection had a positive rate of 92.9% in HPV (+) group and 56.7% in HPV (-) group, the difference between the two groups was statistically significant . Conclusion: The determination of ER in cervical tissue of CIN lesion can help to determine the degree of lesion and guide the treatment. Cervical conization after local ER expression increased, may promote the proliferation of HPV is one of the important causes of persistent HPV infection.