Gao W, Ding L, Song Z C, Feng M J, Liu C L, Li X X, Song L, Lyu Y J, Wang J T
Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Jan 6;54(1):92-98. doi: 10.3760/cma.j.issn.0253-9624.2020.01.017.
To investigate the role of human papillomavirus (HPV) 16 early genes E2 and E6 and heterogeneous nuclear ribonucleoprotein (hnRNP) E2 and their interaction effects in the progression of the cervical cancer. Women with normal cervix (NC), low cervical intraepithelial neoplasia (CIN Ⅰ) and high cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ) from the cervical lesions cohort in Jiexiu County of Shanxi Province from June 2014 to September 2014, and patients with cervical squamous cell carcinoma (SCC) treated at the Second Hospital of Shanxi Medical University in the same period were enrolled in this study. There were 257 participants, about 67 NC cases (26.07%), 69 CIN Ⅰ cases (26.85%), 68 CIN Ⅱ/Ⅲ cases (26.46%), and 53 SCC cases (20.62%), respectively. The information of demographic characteristics, life health habits and cervical lesions were collected by using the structured questionnaire. Cervical exfoliated cells and cervical biopsy tissues were collected to detect the infection of HPV16 and the protein expression levels of hnRNP E2, HPV16 E2 and E6. According to the median-value of the protein expression levels of hnRNP E2, HPV16 E2 and E6 and E2/E6 ratio in the NC group, the study participants were divided into the high and low expression groups/ratio groups. The multivariate logistic regression model was used to analyze the correlation between HPV16 early gene E2 and E6, hnRNP E2 and cervical cancer. The interaction effect was analyzed by using the generalized multifactor dimensionality reduction (GMDR) model. The ages of NC, CIN Ⅰ, CIN Ⅱ/Ⅲ and SCC groups were (47.00±9.07), (47.64±7.35), (46.37±8.67) and (51.26±8.03) years old, respectively. The multivariate logistic regression model analysis showed that the HPV16 E2 low expression, E6 high expression and E2/E6 low ratio could increase the risk of CIN Ⅱ/Ⅲ, about (95) values 11.11 (1.63-75.56), 8.00 (1.28-50.04), and 9.75 (1.22-77.72), respectively and SCC, about (95) values 14.22 (2.11-95.88), 10.33 (1.67-64.00), and 12.38 (1.56-97.91), respectively. The hnRNP E2 low expression could increase the risk of CIN Ⅱ/Ⅲ and SCC, about (95) values 3.35 (1.39-8.10) and 5.53 (1.54-19.88). The result of GMDR showed that there were interaction effects of the hnRNP E2 low expression, HPV16 E2 low expression and HPV16 E6 high expression in both CIN Ⅱ/Ⅲ and SCC groups. The HPV16 E2 low expression, HPV16 E6 high expression and hnRNP E2 low expression could increase the risk of high-grade cervical intraepithelial neoplasia and cervical cancer, and they might have an important interaction effect in the progression of the cervical cancer.
探讨人乳头瘤病毒(HPV)16早期基因E2和E6、异质性核糖核蛋白(hnRNP)E2及其相互作用在宫颈癌进展中的作用。选取2014年6月至2014年9月山西省介休县宫颈病变队列中宫颈正常(NC)、低级别宫颈上皮内瘤变(CINⅠ)和高级别宫颈上皮内瘤变(CINⅡ/Ⅲ)的女性,以及同期在山西医科大学第二医院接受治疗的宫颈鳞状细胞癌(SCC)患者纳入本研究。共有257名参与者,分别约有67例NC病例(26.07%)、69例CINⅠ病例(26.85%)、68例CINⅡ/Ⅲ病例(26.46%)和53例SCC病例(20.62%)。通过结构化问卷收集人口统计学特征、生活健康习惯和宫颈病变信息。收集宫颈脱落细胞和宫颈活检组织,检测HPV16感染情况以及hnRNP E2、HPV16 E2和E6的蛋白表达水平。根据NC组中hnRNP E2、HPV16 E2和E6蛋白表达水平及E2/E6比值的中位数,将研究参与者分为高表达组/低表达组/高比值组/低比值组。采用多因素logistic回归模型分析HPV16早期基因E2和E6、hnRNP E2与宫颈癌的相关性。采用广义多因素降维(GMDR)模型分析相互作用效应。NC、CINⅠ、CINⅡ/Ⅲ和SCC组的年龄分别为(47.00±9.07)、(47.64±7.35)、(46.37±8.67)和(51.26±8.03)岁。多因素logistic回归模型分析显示,HPV16 E2低表达、E6高表达和E2/E6低比值可增加CINⅡ/Ⅲ的发病风险,其(95)值分别约为11.11(1.63 - 75.56)、8.00(1.28 - 50.04)和9.75(1.22 - 77.72),以及SCC的发病风险,其(95)值分别约为14.22(2.11 - 95.88)、10.33(1.67 - 64.00)和12.38(1.56 - 97.91)。hnRNP E2低表达可增加CINⅡ/Ⅲ和SCC的发病风险,其(95)值分别约为3.35(1.39 - 8.10)和5.53(1.54 - 19.88)。GMDR结果显示,在CINⅡ/Ⅲ和SCC组中,hnRNP E2低表达、HPV16 E2低表达和HPV16 E6高表达之间均存在相互作用效应。HPV16 E2低表达、HPV16 E6高表达和hnRNP E2低表达可增加高级别宫颈上皮内瘤变和宫颈癌的发病风险,且它们在宫颈癌进展中可能具有重要的相互作用效应。