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目的探讨不同宫颈病变组织中HPV16E6、E7基因载量与新疆维吾尔族宫颈癌前病变进展的关系;评价实时荧光定量PCR(FQ-PCR)检测HPV在临床的应用价值。方法收集124例宫颈组织(包括宫颈癌和癌前病)和96例宫颈脱落细胞标本,应用实时荧光定量PCR(FQ-PCR)检测早期基因E6、E7和β-肌动蛋白的拷贝数,分析病毒载量。结果①β-肌动蛋白阳性标本中,正常对照组、宫颈炎组、CIN组和宫颈癌组HPV16E6阳性率分别是3.29%、93.3%、75.7%和83.1%;E7阳性率分别是64.8%、86.6%、81%和100%,E6/E7的检出率随宫颈病变严重程度升高,但宫颈癌、CIN、宫颈炎3组之间E6/E7阳性率无显著性差异(χ2=0.66,P>0.05;χ2=0.08,P>0.05)。②HPV16E6载量(均数±标准差)在正常对照:0.00068±0.00、CINI:1.12±1.98、CIN II:0.69±1.02、CINIII:3.22±7.86、宫颈癌:2.83±4.59。不同病变组病毒载量分布差异有统计学意义(P>0.01),与病变严重程度相关(r=0.83,P<0.01)。③HPV16E7载量(均数±标准差)在正常对照:1.80±5.86、CINI:2220±3894、CIN II:11340±21848、CINIII:7908±1.02、宫颈癌:9194±20478。各级病变载量分布差异有统计学意义(P>0.01),与病变严重程度相关(r=0.754,P<0.01)。结论采用FQ-PCR检测宫颈组织HPV16E6/E7结果显示,病毒载量与新疆维吾尔族妇女宫颈病变程度高度相关,其病毒载量可能是预测宫颈病变的理想指标;FQ-PCR方法检测宫颈病变中HPV DNA载量,具有快速、简便、灵敏度高、特异性强等优点,对宫颈癌的普查和治疗有指导意义。
Objective To investigate the relationship between HPV16E6 and E7 gene load in cervical lesions and the progress of cervical precancerous lesions in Xinjiang Uygur nationality. To evaluate the value of real-time fluorescence quantitative PCR (FQ-PCR) in detecting HPV in clinic. Methods 124 cases of cervical tissue (including cervical cancer and precancerous lesions) and 96 cases of cervical exfoliated cells were collected. The copy number of early genes E6, E7 and β-actin were detected by real-time fluorescence quantitative PCR (FQ-PCR) Viral load. Results ① The positive rates of HPV16E6 in normal control group, cervicitis group, CIN group and cervical cancer group were 3.29%, 93.3%, 75.7% and 83.1% respectively in the β-actin positive samples; the positive rates of E7 were 64.8% and 86.6 The positive rates of E6 / E7 in cervical cancer, CIN and cervicitis were no significant difference (χ2 = 0.66, P > 0.05; χ2 = 0.08, P> 0.05). The load of HPV16E6 (mean ± standard deviation) was 0.00068 ± 0.00 in normal control, 1.12 ± 1.98 in CIN II, 0.69 ± 1.02 in CIN II, 3.22 ± 7.86 in CINIII, and 2.83 ± 4.59 in cervical cancer. The distribution of viral load in different pathological groups was significantly different (P> 0.01), which was related to the severity of the disease (r = 0.83, P <0.01). ③ The load of HPV16E7 (mean ± standard deviation) was 1.80 ± 5.86, CINI: 2220 ± 3894, CIN II: 11340 ± 21848, CINIII: 7908 ± 1.02, and cervical cancer: 9194 ± 20478. The distribution of lesion load at all levels had statistical significance (P> 0.01), which was correlated with the severity of the lesion (r = 0.754, P <0.01). Conclusion The results of HPV16E6 / E7 detection by cervical FQ-PCR showed that the viral load was highly correlated with the degree of cervical lesions in Uygur women in Xinjiang. The viral load may be an ideal index for predicting cervical lesions. FQ-PCR was used to detect HPV in cervical lesions DNA load, with fast, simple, high sensitivity, specificity and other advantages, the census of cervical cancer and treatment has guiding significance.