文章摘要
丁玲,冯美娟,刘春亮,王璐,宋志超,杨倩,李小雪,宋丽,高雯,王金桃.hnRNP K在宫颈上皮内瘤样变中的作用及其与HPV16交互效应[J].中华流行病学杂志,2018,39(12):1630-1635
hnRNP K在宫颈上皮内瘤样变中的作用及其与HPV16交互效应
Effect of hnRNP K and its interaction with HPV16 on cervical intraepithelial neoplasia
收稿日期:2018-06-06  出版日期:2018-12-14
DOI:10.3760/cma.j.issn.0254-6450.2018.12.018
中文关键词: 核不均一核糖核蛋白K  人乳头瘤病毒16型  宫颈上皮内瘤样变  交互效应
英文关键词: Heterogeneous nuclear ribonucleoproteins K  Human papillomavirus type 16  Cervical intraepithelial neoplasia  Interactive effect
基金项目:国家自然科学基金(81473060,81703133,81702583);山西省青年科技研究基金(2015021175)
作者单位E-mail
丁玲 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
冯美娟 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
刘春亮 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
王璐 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
宋志超 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
杨倩 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
李小雪 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
宋丽 030001 太原, 山西医科大学公共卫生学院流行病学教研室  
高雯 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hnRNP K与HPV16感染在宫颈上皮内瘤样变(CIN)中的作用及其交互效应。方法 选取2014年6月至2015年6月在山西省介休市建立的社区队列中经病理学确诊的正常宫颈(NC)女性67例和CIN患者137例(CINⅠ患者69例、CINⅡ/Ⅲ患者68例)为研究对象。采用结构式问卷收集研究对象人口学资料及宫颈病变相关因素的基础上,采集宫颈脱落细胞和宫颈活检或手术组织,应用分子导流杂交法检测HPV16感染状况,并采用Western blot技术检测宫颈组织中hnRNP K蛋白表达水平。采用SPSS 23.0软件对资料进行整理分析,研究对象的人口学特征、相关因素、hnRNP K蛋白和HPV16感染在NC组、CINⅠ和CINⅡ/Ⅲ组的差异通过χ2检验、趋势χ2检验、Kruskal-Wallis H检验进行比较;hnRNP K蛋白表达量的组间两两多重比较采用Bonferroni法;采用非条件logistic回归模型计算hnRNP K蛋白、HPV16感染与CIN的关联强度OR值及其95% CI,采用相加交互模型及交互效应指标评价hnRNP K蛋白和HPV16感染两因素在CIN中的交互效应。结果 CINⅡ/Ⅲ组HPV16感染率(41.2%)高于NC(10.4%)、CINⅠ(14.5%),差异有统计学意义(P<0.001),且随着CIN程度加重,HPV16的感染率呈上升趋势(趋势χ2=18.512)。hnRNP K蛋白表达量在NC组、CINⅠ组和CINⅡ/Ⅲ组间差异有统计学意义(H=48.138,P<0.001),且随着CIN程度加重呈上升趋势(趋势χ2=21.765,P<0.001)。交互效应分析显示,hnRNP K蛋白高表达与HPV16感染在CINⅡ/Ⅲ组存在正相加交互作用(API=0.639,95% CI:0.083~1.196),在CINⅠ组尚未发现存在类似交互作用。结论 hnRNP K蛋白高表达、HPV16感染均可能增加CIN的发生风险,且在高度CIN发生中存在正相加交互作用。
英文摘要:
      Objective To investigate the effect of heterogeneous nuclear ribonucleoprotein K (hnRNP K) and its interaction with human papillomavirus 16 (HPV16) on cervical intraepithelial neoplasia (CIN). Methods The participants included 67 women with normal cervix (NC), 69 women with CINⅠ and 68 women with CINⅡ/Ⅲ in a community cohort of pathologically diagnosed women established in Jiexiu of Shanxi province, from June 2014 to June 2015. A structured questionnaire was used to collect the demographic data of the subjects and the related factors of cervical lesions. Cervical exfoliated cells and cervical tissues from biopsy or surgery were selected. The infection status of HPV16 was detected by flow-through hybridization. The protein expression levels of hnRNP K were evaluated by Western blot. SPSS 23.0 software was used to collate and analyze the data. To study the differences in demographic characteristics, related factors, hnRNP K protein and HPV16 infection among NC, CINⅠand CINⅡ/Ⅲgroups, χ2 test, trend χ2 test, and Kruskal-Wallis H test were conducted. Multiple comparisons of hnRNP K protein in three groups were completed by using the Bonferroni method. The OR and its 95% CI of hnRNP K, HPV16 and CIN were calculated by using the unconditional logistic regression models. Two-way interactions between hnRNP K protein and HPV16 infection on CIN were analyzed by using additive model and related indicators. Results HPV16 infection rates were 10.4% in women with normal cervix, 14.5% in women with CINⅠand 41.2% in women with CINⅡ/Ⅲ, respectively. The differences among three groups were significant (P<0.001). Moreover, the infection rates of HPV16 gradually increased with the increasing severity of CIN (trend χ2=18.512, P<0.001). The differences in protein expression of hnRNP K among three groups were significant (H=48.138, P<0.001) and the expressionincreased with the development of cervical lesionss (trend χ2=21.765, P<0.001). Results from the interaction analysis indicated that there were additive effects between high expression of hnRNP K protein and HPV16 in CINⅡ/Ⅲ group compared with normal group (API=0.639, 95% CI:0.083-1.196). In contrast, no such additive effect was found in CINⅠ group. Conclusions HPV16 infection and over-expression of hnRNP K protein were associated with the increased risk of cervical intraepithelial neoplasia. There might be interaction between hnRNP K protein overexpression and HPV16 infection existed on the progress of CINⅡ/Ⅲ.
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