Nicol Alcina F, Brunette Laurie L, Nuovo Gerard J, Grinsztejn Beatriz, Friedman Ruth K, Veloso Valdiléa G, Cunha Cynthia B, Coutinho José R, Vianna-Andrade Cecilia, Oliveira Nathalia S, Woodham Andrew W, DA Silva Diane M, Kast W Martin
Laboratory of Interdisciplinary Medical Research, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Norris Comprehensive Cancer Center, Departments of Obstetrics & Gynecology and Molecular Microbiology & Immunology, University of Southern California, Los Angeles, California, USA.
J Acquir Immune Defic Syndr. 2016 Sep 1;73(1):27-33. doi: 10.1097/QAI.0000000000001049.
The aim of this study was to evaluate secretory leukocyte protease inhibitor (SLPI) expression in anal biopsies from HIV-positive (HIV+) individuals, and compare that to anal intraepithelial neoplasia (AIN) diagnoses and human papillomavirus (HPV) status.
This is a cross-sectional study of a cohort of 54 HIV+ (31 males and 23 females) from an AIDS clinic in Rio de Janeiro, Brazil.
The study material consisted of anorectal tissue biopsies obtained from HIV+ subjects, which were used to construct tissue microarray paraffin blocks for immunohistochemical analysis of SLPI expression. Biopsies were evaluated by an expert pathologist and classified as low-grade AIN1, high-grade AIN2/3, or normal squamous epithelium. In addition, DNA from the biopsies was extracted and analyzed for the presence of low- or high-risk HPV DNA.
Histologically, normal squamous epithelium from the anorectal region showed strong positive SLPI staining in 17/20 (85%) samples. In comparison, 9/17 (53%) dysplastic squamous epithelial samples from AIN1 patients showed strong SLPI staining, and only 5/17 (29%) samples from AIN2/3 patients exhibited strong SPLI staining, which both were significantly fewer than those from normal tissue (P = 0.005). Furthermore, there was a significantly higher proportion of samples in which oncogenic high-risk HPV genotypes were detected in low SLPI-expressing tissues than that in tissues with high SLPI expression (P = 0.040).
Taken together these results suggest that low SLPI expression is associated with high-risk HPV infections in the development of AIN.
本研究旨在评估HIV阳性（HIV+）个体肛门活检组织中分泌型白细胞蛋白酶抑制剂（SLPI）的表达情况，并将其与肛门上皮内瘤变（AIN）诊断结果及人乳头瘤病毒（HPV）状态进行比较。
这是一项对来自巴西里约热内卢一家艾滋病诊所的54名HIV+患者（31名男性和23名女性）队列的横断面研究。
研究材料包括从HIV+受试者获取的肛肠组织活检样本，这些样本用于构建组织微阵列石蜡块，以进行SLPI表达的免疫组织化学分析。活检样本由一名专业病理学家进行评估，并分类为低级别AIN1、高级别AIN2/3或正常鳞状上皮。此外，从活检样本中提取DNA，分析是否存在低风险或高风险HPV DNA。
组织学上，肛肠区域的正常鳞状上皮在17/20（85%）的样本中显示出强烈的SLPI阳性染色。相比之下，AIN1患者的17个发育异常鳞状上皮样本中有9个（53%）显示出强烈的SLPI染色，而AIN2/3患者的样本中只有5/17（29%）显示出强烈的SPLI染色，这两者均明显少于正常组织样本（P = 0.005）。此外，在低SLPI表达组织中检测到致癌性高风险HPV基因型的样本比例明显高于高SLPI表达组织（P = 0.040）。
综合这些结果表明，低SLPI表达与AIN发生过程中的高风险HPV感染相关。
