| Objective: To study the expression and differentiation of HPV L1 capsid protein and h TERC gene in cervical cell between Uygur and Han women in Xinjiang, and evaluate the diagnostic value of HPV L1 capsid protein, hTERC gene, and HPV L1 capsid protein combined with h TERC gene. Methods: From September 2012 to March 2014, 1160 cases that consulted a doctor or had an opportunistic screening of cervical cancer were collected in the department of Xinjiang Uygur Autonomous Region People’s Hospital. All the cases were examined with ThinPrep Cytology Test(TCT) and HPV genotyping. The cases with HPV infection positive or TCT positive or the both positive were included in the study cohort. All the cases included in the study cohort underwent colposcopy and biopsy, and the expression of HPV L1 capsid protein was detected with immunocytochemical method, and the expression of hTERC gene was detected with fluorescence chromosomal in situ hybridization(FISH). Results:(1) The abnormal rate of TCT examination had no significant difference between Uygur and Han women, and the constituent ratio of ASCUS, LSIL, HSIL and SCC had no significant difference; the positive rate of HPV infection had no significant difference between Uygur and Han women, and the constituent ratio of high-risk HPV infection, mixed HPV infection and low-risk HPV infection had no significant difference.(2) The total positive rate of hTERC gene amplification had no significant difference between Uygur and Han women, and the positive rate of h TERC gene amplification in NILM group, ASCUS group, LSIL group, HSIL group and SCC group had no significant difference between Uygur and Han women, and the positive rate of hTERC gene amplification in normal or chronic inflammation group, CIN1 group, CIN2 group, CIN3 group and SCC group had no significant difference between Uygur and Han women; gene copy number and distribution ratio(TERC: CEP) of normal or chronic inflammation group / CIN1 group and CIN2 + group had no significant difference between Uygur and Han women.(3) For cytology groups, the order of the positive rate of hTERC gene amplification was SCC group ≈HSIL group> LSIL group> ASCUS group ≈NILM group; for histology groups, the order of the positive rate of hTERC gene amplification was SCC group ≈CIN3 group> CIN2 group> CIN1 group ≈ normal or chronic inflammation group.(4) The total positive rate of HPV L1 capsid protein had no significant difference between Uygur and Han women, and the positive rate in normal or chronic inflammation group, the positive rate CIN1 group, CIN2 group, CIN3 group and SCC group had also no significant difference, and the positive rate in normal or chronic inflammation group, the positive rate in NILM group, ASCUS group, LSIL group, HSIL group and SCC group had also no significant difference.(5) For Uygur and Han women in Xinjiang, the positive rate of HPV L1 capsid protein was highest in CIN1 group, higher than normal or chronic inflammatory group and other high CIN group; for different CIN groups, the positive rate of HPV L1 capsid protein decreased with increasing malignancy; the positive rate of HPV L1 capsid protein was highest in LSIL group, higher than NILM group, ASCUS group and other higher-level groups. Moreover, the positive rate of HPV L1 capsid protein decreased with increasing cytology grade starting from LSIL group.(6) For Uygur and Han women with positive HPV infection, the total positive rate of HPV L1 capsid protein had no significant difference between Uygur and Han women, and the positive rate in high-risk HPV infection, mixed HPV infection and low-risk HPV infection had no significant difference. But the positive rate of HPV L1 capsid protein was higher in mixed HPV infection and low-risk HPV infection than high-risk HPV infection.(7) HPV L1 capsid protein should be applied in screening / diagnosing high-grade cervical lesions CIN2~+ from CIN 1+ patients for Uygur and Han women in Xinjiang. The sensitivity, accuracy and positive predictive value were high, and the specificity and negative predictive value were low, there was no significant difference between Uygur and Han women. Its diagnostic value was acceptable(the area under ROC curve: 0.699 for Uygur, 0.705 for Han).(8) hTERC gene should be applied in screening / diagnosing high-grade cervical lesions CIN2~+ from normal or chronic inflammation patients and CIN 1+ patients for Uygur and Han women in Xinjiang. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were high, and there was no significant difference between Uygur and Han women. Its diagnostic value was high(the area under ROC curve: 0.875 for Uygur, 0.871 for Han).(9) HPV L1 capsid protein combined with h TERC gene should be applied in screening / diagnosing high-grade cervical lesions CIN2~+ from CIN 1+ patients for Uygur and Han women in Xinjiang. The sensitivity, accuracy and positive predictive value were high, and the specificity and negative predictive value were low, and there was no significant difference between Uygur and Han women. Its diagnostic value was acceptable(the area under ROC curve: 0.706 for Uygur, 0.699 for Han).(10) When applied in CIN1+ patients, the diagnostic efficiency was: hTERC gene > HPV L1 capsid protein combined with hTERC gene ≈ HPV L1 capsid protein according to Z test.(11) HPV L1 / hTERC expression status was HPVL1(-) / h TERC(-), L1(+) / hTERC(-), HPVL1(+) / hTERC(+) and HPVL1(-) / h TERC(+) with increasing severity of cervical lesions. Conclusions:(1) The expression of hTERC gene and HPV L1 capsid protein had no significant difference between Uygur and Han women in Xinjiang.(2) h TERC gene expression was positively correlated with the malignancy of cervical lesions, and HPV Ll capsid protein showed a negative correlation for Uygur and Han women in Xinjiang.(3) HPV L1 capsid protein should be applied in screening / diagnosing high-grade cervical lesions CIN2~+ from CIN 1+ patients for Uygur and Han women in Xinjiang; the sensitivity, accuracy and positive predictive value were high, and the specificity and negative predictive value were low, there was no significant difference between Uygur and Han women; its diagnostic value was acceptable. h TERC gene should be applied in screening / diagnosing high-grade cervical lesions CIN2~+ from normal or chronic inflammation patients and CIN 1+ patients, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were high, and there was no significant difference between Uygur and Han women; its diagnostic value was high. HPV L1 capsid protein combined with hTERC gene should be applied in screening / diagnosing high-grade cervical lesions CIN2~+ from CIN 1+ patients, and the sensitivity, accuracy and positive predictive value were high, and the specificity and negative predictive value were low, and there was no significant difference between Uygur and Han women; its diagnostic value was acceptable.(4) in conclusion, the diagnostic efficiency was higher in hTERC gene than in HPV L1 capsid protein and HPV L1 capsid protein combined with hTERC gene.(5) The expression status of HPV L1 / h TERC changed depending on the severity of cervical lesions, and its expression may reflect the timing of the development of cervical lesions. |
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