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目的:探讨血浆中载脂蛋白AⅠ(apoAⅠ)含量和哺乳动物雷帕霉素靶蛋白(mTOR)活性在维吾尔族妇女宫颈病变进程中的动态变化及评价其对于宫颈癌预警的灵敏度、特异性和准确性。方法:收集新疆地区维吾尔族宫颈病变血浆样本共82例(宫颈炎22例,CINⅡ~Ⅲ20例,宫颈癌早期20例,宫颈癌晚期20例),用酶联免疫法检测血浆中apoAⅠ蛋白含量和mTOR活性,分析其与宫颈病变进程的关系及相关性,评价其对于宫颈癌预警的灵敏度、特异性和准确性。结果:随着宫颈炎到CINⅡ~Ⅲ、宫颈癌早期和晚期发病过程,血浆apoAⅠ含量明显降低而mTOR活性上升,与正常对照宫颈炎组比较,其差异均有统计学意义(P<0.05);apoAⅠ的表达与mTOR活性呈低度负相关(r<0.4,<0.05);血浆mTOR活性的预警灵敏度、特异度和准确度较高,分别为94.0%、60.0%、80.0%,而apoAⅠ分别为70.1%、60.0%、29.0%。从不同指标联合检测的角度分析,apoAⅠ和mTOR联合检测的灵敏度、特异度和准确度分别为82.1%、60.0%、54.5%。结论:维吾尔族妇女宫颈癌发生发展与血浆中apoAⅠ含量和mTOR活性动态变化密切相关,可以成为宫颈癌早期诊断的预警或疗效评估的重要指标。
Objective: To investigate the dynamic changes of plasma apolipoprotein AⅠ (apoAⅠ) and mammalian target of rapamycin (mTOR) activity in Uygur women with cervical lesions and to evaluate the sensitivity, specificity and accuracy. Methods: A total of 82 samples of Uyghur cervical lesions in Xinjiang were collected (22 cases of cervicitis, 20 cases of CINⅡ-Ⅲ, 20 cases of early cervical cancer and 20 cases of advanced cervical cancer). The content of apoAI protein in plasma was detected by enzyme-linked immunosorbent assay mTOR activity, analysis of its relationship with the process of cervical lesions and correlation, evaluate its sensitivity, specificity and accuracy for cervical cancer warning. Results: With the progression of cervicitis to CIN Ⅱ ~ Ⅲ and cervical cancer in early stage and advanced stage, plasma apoA Ⅰ level decreased and mTOR activity increased. Compared with normal control cervicitis group, the difference was statistically significant (P <0.05). The expression of apoAⅠwas negatively correlated with mTOR activity (r <0.4, <0.05). The early warning sensitivity, specificity and accuracy of plasma mTOR activity were 94.0%, 60.0% and 80.0% respectively, while the apoAⅠwere 70.1%, 60.0%, 29.0%. The sensitivity, specificity and accuracy of the combined detection of apoAⅠand mTOR were 82.1%, 60.0% and 54.5%, respectively, from the perspective of joint detection of different indicators. Conclusions: The occurrence and development of cervical cancer in Uyghur women are closely related to the dynamic changes of apoAI content and mTOR activity in plasma, which may be an important index for early warning or curative evaluation of cervical cancer.