CAJ | 학술논문

目的探讨红细胞叶酸和p16基因表达与子宫颈癌发生发展的关系以及二者的交互效应.方法选择经病理学确诊的子宫颈炎(CI)患者58例、低度子宫颈上皮内瘤变(CIN Ⅰ)患者52例、高度子宫颈上皮内瘤变(CINⅡ～Ⅲ)患者60例和子宫颈鳞状细胞癌(SCC)患者76例作为研究对象.在收集人口学特征和子宫颈病变相关因素的基础上,检测红细胞叶酸水平(微生物法)、人乳头状瘤病毒16(HPV16)的感染状况(PCR法)、子宫颈组织中p16基因mRNA(实时定量PCR法)和蛋白表达水平(Western blot法).结果红细胞叶酸水平在CI组为(285.66±48.08) ng/ml,CIN Ⅰ组为(268.70±46.01) ng/ml,CINⅡ～Ⅲ组为(251.22±32.20)ng/ml,SCC组为(226.21±44.79)ng/ml,随着子宫颈病变程度的加重,红细胞叶酸水平呈下降趋势(x 2趋势=32.39,P＜ 0.001);p16 mRNA及蛋白表达水平逐渐升高(x 2趋势=24.68,P＜ 0.001;x2趋势=45.84,P＜0.001);红细胞叶酸与p16mRNA及蛋白表达均呈负相关关系(r=-0.114,P＜ 0.001;r=-0.192,P＜ 0.001).交互作用分析显示,红细胞叶酸缺乏与p16 mRNA及蛋白高表达在CIN Ⅰ组、CINⅡ～Ⅲ组及SCC组均显示正相加交互作用.结论红细胞叶酸缺乏和p16 mRNA及蛋白高表达均可增加子宫颈癌变发生的风险,两者在子宫颈癌及其癌前病变中可能存在正相加交互作用.
목적 탐토홍세포협산화p16기인표체여자궁경암발생발전적관계이급이자적교호효응.방법 선택경병이학학진적자궁경염(CI)환자58례、저도자궁경상피내류변(CIN Ⅰ)환자52례、고도자궁경상피내류변(CINⅡ～Ⅲ)환자60례화자궁경린상세포암(SCC)환자76례작위연구대상.재수집인구학특정화자궁경병변상관인소적기출상,검측홍세포협산수평(미생물법)、인유두상류병독16(HPV16)적감염상황(PCR법)、자궁경조직중p16기인mRNA(실시정량PCR법)화단백표체수평(Western blot법).결과 홍세포협산수평재CI조위(285.66±48.08) ng/ml,CIN Ⅰ조위(268.70±46.01) ng/ml,CINⅡ～Ⅲ조위(251.22±32.20)ng/ml,SCC조위(226.21±44.79)ng/ml,수착자궁경병변정도적가중,홍세포협산수평정하강추세(x 2추세=32.39,P＜ 0.001);p16 mRNA급단백표체수평축점승고(x 2추세=24.68,P＜ 0.001;x2추세=45.84,P＜0.001);홍세포협산여p16mRNA급단백표체균정부상관관계(r=-0.114,P＜ 0.001;r=-0.192,P＜ 0.001).교호작용분석현시,홍세포협산결핍여p16 mRNA급단백고표체재CIN Ⅰ조、CINⅡ～Ⅲ조급SCC조균현시정상가교호작용.결론 홍세포협산결핍화p16 mRNA급단백고표체균가증가자궁경암변발생적풍험,량자재자궁경암급기암전병변중가능존재정상가교호작용.
Objective To explore the interaction effects between blood folate and p16 gene expression in the progression of cervical cancerization.Methods The study participants included 58 patients with cervical inflammation (CI),52 patients with cervical intraepithelial neoplasm Ⅰ (CIN Ⅰ),60 patients with cervical intraepithelial neoplasm Ⅱ-Ⅲ (CIN Ⅱ-Ⅲ) and 76 patients with cervical squamous cell carcinoma (SCC),who were diagnosed by pathology.On the basis of collecting the demography information and cervical cancerization factors by structured questionnaire,blood folate levels were detected by microbiological assay,HPV16 infection status was determined by PCR,the expressions of p16 mRNA and protein were detected by real-time PCR and Western blot,respectively.Results The level of blood folate was (285.66±48.08) ng/ml in CI group,(268.70±46.01) ng/ml in CIN Ⅰ group,(251.22±32.20) ng/ml in CINⅡ-Ⅲ group,(226.21±44.79) ng/ml in SCC group.Blood folate levels were decreased gradually with the deterioration of the cervical lesion (x2trend =32.39,P ＜ 0.001),whereas levels of p16 mRNA expression (x2trend =24.68,P ＜ 0.001) and protein expression (x2trend =45.84,P ＜ 0.001) were increased.The levels of blood folate were negatively correlated with p16 mRNA expression (r =-0.114,P ＜ 0.001) or protein expression (r =-0.192,P ＜ 0.001),and there was an additive interaction between blood folate deficiency and p16 mRNA or protein expression in CIN and SCC as well.Conclusions Both blood folate deficiency and high expression of p16 mRNA or protein could increase the risk of cervical cancerization,there may be a synergistic action between blood folate and p16 in the progression of cervical cancerization.