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[目的]研究轻度宫颈上皮内瘤变(CIN1)的转归,并探索p16基因甲基化能否成为预测其预后的生物学指标。[方法]以2002年山西省阳城县人群子宫颈癌筛查发现的CIN1患者和宫颈正常者为研究对象,抽取所有的CIN1共139例,同时随机抽取正常120例,运用甲基化特异性PCR(MS-PCR)-DH-PLC组合检测技术对基线病理蜡块进行p16基因甲基化检测。追踪随访CIN1患者6年,观察病变的转归,并评价p16基因甲基化对CIN1病变进展的危险性。[结果]随访6年后,CIN1病变逆转、持续和进展的比例分别为70.3%、13.2%和16.5%。对基线标本进行p16基因甲基化检测,CIN1组的甲基化率(24.2%)高于正常组(17.6%),但差别无统计学意义(χ2=1.60,P=0.21);基线HPVDNA阳性组的甲基化率(23.5%)高于阴性组(15.6%),差别无统计学意义(χ2=2.01,P=0.17)。CIN1中甲基化和非甲基化组病变持续或进展的比例分别为20.0%和34.9%,差异无统计学意义(χ2=2.30,P=0.13),病变预后与p16基因甲基化状态无明显关联(RR=0.57,0.26～1.24)。[结论]经过6年随访,约有三分之二的CIN1逆转,仅有三分之一的病变维持原状或发生进展。尚不能证明CIN1病变进展与p16基因甲基化有关,该指标不能用于预测CIN1的预后。
[Objective] To investigate the prognosis of mild cervical intraepithelial neoplasia (CIN1) and explore whether methylation of p16 gene can be used as a biological indicator to predict its prognosis. [Methods] The CIN1 patients and normal cervix discovered by cervical cancer screening in Yangcheng County of Shanxi Province in 2002 were selected as the research object. All 139 patients with CIN1 were selected and 120 normal subjects were selected randomly. Methylation specificity PCR (MS-PCR) -DH-PLC combination detection of baseline pathological paraffin block p16 gene methylation detection. Follow-up CIN1 patients were followed up for 6 years, the prognosis of the lesions was observed, and the risk of methylation of p16 gene in the progression of CIN1 lesions was evaluated. [Results] After 6 years of follow-up, the CIN1 lesions were reversed, sustained and progress were 70.3%, 13.2% and 16.5% respectively. The methylation of p16 gene was detected in baseline samples. The methylation rate in CIN1 group (24.2%) was higher than that in normal group (17.6%), but the difference was not statistically significant (χ2 = 1.60, P = 0.21) The methylation rate (23.5%) was higher in the group than in the negative group (15.6%), with no significant difference (χ2 = 2.01, P = 0.17). The proportion of persistent or progressive lesions in methylation and non-methylation groups in CIN1 was 20.0% and 34.9%, respectively, with no significant difference (χ2 = 2.30, P = 0.13), prognosis and p16 methylation status Significant correlation (RR = 0.57, 0.26 ~ 1.24). [Conclusions] After 6 years of follow-up, about two-thirds of CIN1 are reversed and only one-third of lesions remain the same or progress. CIN1 lesions have not yet proved the progress of p16 gene methylation, the index can not be used to predict the prognosis of CIN1.