Oliveira Ana, Delgado Candida, Verdasca Nuno, Pista Angela
Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Doutor Ricardo Jorge, I.P. Lisboa, Portugal.
Acta Med Port. 2013 Mar-Apr;26(2):139-44. Epub 2013 May 31.
INTRODUCTION/OBJECTIVE: Persistent infection with high-risk human papillomavirus (HPV) types is a necessary cause for cervical cancer development. The aim of this study was to evaluate the significance of different molecular markers for cervical carcinogenesis, and to assess their association with cervical intraepithelial neoplasia.
378 cervical samples from women attending to primary Health Clinics of the National Health Service and Gynaecological Outpatient Clinics and referred for HPV testing were analyzed between between January 2007 and December 2010. According to cytological diagnosis, five groups were defined: normal, ASCUS, LSIL, HSIL, and ICC. For the determination of viral DNA physical status was performed by using a real-time PCR methodology, over expression of E6/E7 mRNA NASBA amplification was performed with the NucliSENS EasyQ HPV assay and viral load was determined by a real-time PCR. HPV status was studied in relation to lesion severity. Statistical analysis was performed with SPSS software 16.0 and Chi-Square test.
No significant statistical differences were found between the physical status of HPV 16 or 18 and lesion severity. Overexpression of E6/E7 mRNA increased with lesion severity. Viral load was significantly associated with the development of cervical intraepithelial lesion.
Data suggests that viral integration for HPV 16 seems to be an early event on cervical carcinogenesis, not being suitable as a molecular marker. E6/E7 mRNA and viral load can be more valuable approaches to use as biomarkers in the prevention of cervical cancer development.
引言/目的:高危型人乳头瘤病毒(HPV)的持续感染是宫颈癌发生的必要原因。本研究旨在评估不同分子标志物在宫颈癌变中的意义,并评估它们与宫颈上皮内瘤变的相关性。
对2007年1月至2010年12月期间,来自国家卫生服务初级保健诊所和妇科门诊、转诊进行HPV检测的378例宫颈样本进行分析。根据细胞学诊断,分为五组:正常、非典型鳞状细胞(ASCUS)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)和浸润性宫颈癌(ICC)。采用实时PCR方法测定病毒DNA的物理状态,使用NucliSENS EasyQ HPV检测法进行E6/E7 mRNA的过表达NASBA扩增,并通过实时PCR测定病毒载量。研究HPV状态与病变严重程度的关系。使用SPSS软件16.0进行统计分析和卡方检验。
HPV 16或18的物理状态与病变严重程度之间未发现显著统计学差异。E6/E7 mRNA的过表达随病变严重程度增加。病毒载量与宫颈上皮内病变的发生显著相关。
数据表明,HPV 16的病毒整合似乎是宫颈癌变的早期事件,不适宜作为分子标志物。E6/E7 mRNA和病毒载量可能是预防宫颈癌发生更有价值的生物标志物检测方法。