Expression And Significance Of CK17in The High-risk HPV Infection Of Cervical Lesions

Objective：1.To acknowledge the status of infecton of human papillomavirus（HPV）incervix, investigate the clinical value of human papillomavirus deoxyribonucleic acid(HPV DNA) testing in cervical lesions,and combine with Thin-prep liquid-basedCytology Test (TCT) result to evaluate the sceening programs of cervical cancer.2. Tostudy the expression of cytokerratin17(CK17) in normal cervix and cervical lesions,combined with cervical’s HPV infection, discuss the relationship between CK17’sexpression and HR-HPV infection in cervical tissue, and investigate the clinicalsignificance of CK17’s abnormal expression is used to predict the development ofcervical lesions.Methods：1. The technology of Flow-through hybridization and gene chip was used todectect the type of HPV,combine with the pathologic result,analysis and compare theefficiency of TCT and HPV detection to diagnose the cervical lesions.2.Immunohistochemistry method was used to detect CK17’s expression in normal cervixand cervical lesions, which infected or not by HR-HPV.3. Correlation analysis was usedto detect the correlation between CK17’s expression and HR-HPV infection on cervicaltissue.Results：1. In the study of142cases, HR-HPV infection rate was79.58%(113/142),CK17positive expression rate was62.67%(65/142), and in the group of HR-HPVpositive, CK17positive expression rate was53.1%(60/113), while in the group of HR-HPV negative, it was17.2%(5/29), expression rate differences between the two grouphad statistically significant (X2=11.95, P <0.05).Devide the experimental cases intofour groups named A.B.C.and D by pathologic diagnoses. Group A include48casesdiagnosed as chronic cervicitis, group B include17cases diagnosed as CINI, group C include63cases diagnosed as CINII/CINIII and group D include14cases diagnosed ascervical cancer. In the four groups, the positive expression rate of CK17graduallyincreased,2.08%(1/48),23.53%(4/17),76.19%(48/63),85.71%(12/14), respectively,the statistical results show that the expression rate of CK17in four groups weredifferent and the difference had statistically significant (X2=72.78, P <0.05).2. Among the four groups, HR-HPV infection rate was64.6%(31/48),76.5%(13/17),88.9%(56/63),92.9%(13/14), respectively, and C, D groups’ infection rate higher thanthat of group A,B, the difference was statistically significant (X2=10.419,P <0.05);Correlation analysis showed that the positive expression rate of CK17and HR-HPVinfection was positively correlated (r=0.98, P <0.05).3. As HR-HPV detection is used independently to predict high grade cervical lesions,thesensibility is89.6%, the pecificity is32.3%, the positive predictive value is71.1%, thenegative value is72.4%; As the result of TCT≥ASCUS is used independently to predicthigh grade cervical lesions,the sensibility is87.0%, the pecificity is53.8%, the positivepredictive value is69.1%, the negative value is77.8%; As HR-HPV detection combinewith the result of TCT≥ASCUS is used to predict high grade cervical lesions, thesensibility is98.6%, the pecificity is17.4%, the positive predictive value is58.5%, thenegative value is77.8%.Conclusions：1. With the increase of cervical intraepithelial lesion level, theexpression of CK17was also on the rise, CK17may play a role in the development ofcervical lesions.2. CK17expression and HR-HPV infection are positively correlated,CK17has played a role in the mechanism of HR-HPV infection induced cervicalintraepithelial neoplasia.3. HPV DNA testing can understand the high-risk HPVassociated with cervical cancer, combine with HR-HPV detection and cervical TCTexamination is still a good screening programs nowadays.