叶酸与HPV16 E6/E7 mRNA表达在宫颈癌变中的交互作用

南晶; 丁玲; 刘学智; 李娟; 吴婷婷; 陈霄; 王金桃

文章摘要

南晶,丁玲,刘学智,李娟,吴婷婷,陈霄,王金桃.叶酸与HPV16 E6/E7 mRNA表达在宫颈癌变中的交互作用[J].中华流行病学杂志,2016,37(6):852-857

叶酸与HPV16 E6/E7 mRNA表达在宫颈癌变中的交互作用

Interaction between folate and the expression of human papillomavirus 16 E6/E7 mRNA in the progression of cervix carcinogenesis

收稿日期:2015-10-28 出版日期:2016-06-14

DOI：10.3760/cma.j.issn.0254-6450.2016.06.022

中文关键词: 宫颈癌变叶酸人乳头瘤病毒16型E6/E7 mRNA

英文关键词: Cervix carcinogenesis Folate Human papillomavirus 16 E6/E7 mRNA

基金项目:国家自然科学基金(30872166,81273157,81473060);山西省自然科学基金(2008011075-1)

作者	单位	E-mail
南晶	030001 太原, 山西医科大学公共卫生学院流行病学教研室
丁玲	030001 太原, 山西医科大学公共卫生学院流行病学教研室
刘学智	030001 太原, 山西医科大学公共卫生学院流行病学教研室
李娟	030001 太原, 山西医科大学公共卫生学院流行病学教研室
吴婷婷	030001 太原, 山西医科大学公共卫生学院流行病学教研室
陈霄	030001 太原, 山西医科大学公共卫生学院流行病学教研室
王金桃	030001 太原, 山西医科大学公共卫生学院流行病学教研室	wangjt59@163.com

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中文摘要:

目的探讨叶酸与人乳头瘤病毒16型(HPV16)E6/E7 mRNA表达在宫颈癌变中的交互作用。方法选取经病理学确诊的宫颈鳞状细胞癌(SCC)患者64例、低度宫颈上皮内瘤样变(CIN1)患者55例、高度宫颈上皮内瘤样变(CIN2+)患者55例和正常宫颈(NC)者80例作为研究对象。采用微生物法测定血清叶酸和红细胞叶酸水平,应用real-time PCR法检测HPV16 E6/E7 mRNA表达水平。利用SPSS 16.0软件进行相关资料的χ²检验、方差分析、Welch检验、Kruskal-Wallis H检验、有序logistic回归和Spearman秩相关分析,应用相加模型进行交互作用分析。结果随着宫颈癌变的进展,血清叶酸和红细胞叶酸水平均呈逐渐降低趋势(χ²=32.71,P<0.001; χ²=16.32,P<0.001),且血清叶酸和红细胞叶酸含量呈正相关(r=0.41,P<0.001);HPV16 E6/E7 mRNA表达水平随着宫颈癌变的进展呈逐渐升高趋势(χ²=30.11,P<0.001; χ²=38.99,P<0.001);红细胞叶酸含量与HPV16 E6/E7 mRNA表达量呈负相关(E6:r=-0.14,P=0.009;E7:r=-0.21,P=0.001),红细胞叶酸缺乏与HPV16 E6/E7mRNA高表达在CIN1、CIN2+和SCC组均存在正相加交互作用。结论叶酸缺乏和HPV16 E6/E7 mRNA高表达均可增加宫颈癌及癌前病变发生的风险,两者在宫颈癌变进展中存在协同作用。

英文摘要:

Objective To explore the interaction between folate and the expression of HPV16 E6/E7 mRNA in the progression of cervix carcinogenesis. Methods Subjects were selected from the participants who were diagnosed pathologically, including 64 patients with cervical squamous cell carcinoma (SCC), 55 patients with low-grade cervical intraepithelial neoplasm (CIN1), 55 patients with high-grade cervical intraepithelial neoplasm (CIN2+) and 80 with normal cervix (NC). The levels of serum folate and RBC folate were detected by microbiological assay, and the expression levels of HPV16 E6/E7 mRNA were measured, using the real-time polymerase chain reaction (real-time PCR). Data was analyzed by methods as chi-square test, analysis of variance (ANOVA), Welch test, Kruskal-Wallis H test and ordinal logistic regression. Spearman correlation was tested using the SPSS statistical software (version 16.0) while the interaction effects were evaluated by additive model. Results There was a positive correlation seen between the serum folate and RBC folate (r=0.41, P<0.001). The levels of serum folate and RBC folate decreased gradually along with the severity of cervical lesions (χ²=32.71, P<0.001; χ²=16.32, P<0.001). The expression levels of HPV16 E6/E7 mRNA increased gradually with the severity of cervical lesions (χ²=30.11, P<0.001; χ²=38.99, P<0.001). There was a negative correlation between the levels of RBC folate, expression levels of HPV16 E6 (E6:r=-0.14, P=0.009) and HPV16 E7 mRNA (E7:r=-0.21, P=0.001), respectively. Both RBC folate deficiency and HPV16 E6/E7 mRNA high expression showed additive interaction in CIN1,CIN2+ and SCC. Conclusion Folate deficiency and high expression of HPV16 E6/E7 mRNA might increase the risk of cervical cancer and cervix precancerous lesions, and having a synergistic action in the progression of cervix carcinogenesis.

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