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目的：研究宫颈癌（CC）组织微小核糖核酸（miR）-205、α-嵌合蛋白（CHN1）表达与高危型人乳头瘤病毒（HPV）感染及预后的关系。方法：选取2018年1月~2021年2月徐州医科大学附属徐州市立医院收治的182例CC患者纳入CC组，另选取徐州医科大学附属徐州市立医院同期收治的150例宫颈上皮内瘤变（CIN）患者纳入CIN组和150例宫颈炎患者纳入宫颈炎组。比较三组病变组织CHN1高表达率、miR-205相对表达量及高危型HPV阳性感染率。比较不同高危型HPV感染类型、病毒负荷量的CC患者CHN1高表达率和miR-205相对表达量。比较不同临床病理特征的CC患者CHN1、miR-205高表达率。采用Spearman检验分析CHN1、miR-205表达情况与CC患者高危型HPV感染的相关性。CC患者随访3年，采用Kaplan-Meier法和Log-Rank检验分析CHN1、miR-205低、高表达组CC患者3年总体生存率。结果：CC组CHN1高表达率、miR-205相对表达量及高危型HPV阳性感染率高于CIN组和宫颈炎组，且CIN组CHN1高表达率、miR-205相对表达量及高危型HPV阳性感染率高于宫颈炎组（P＜0.05）。166例高危型HPV阳性感染的CC患者中，病毒负荷量越高的患者CHN1高表达率、miR-205相对表达量越高，且多重感染者CHN1高表达率、miR-205相对表达量显著高于单一感染者（P＜0.05）。年龄、肿瘤直径、病理类型、分化程度不同的CC患者间CHN1、miR-205高表达率对比没有统计学差异（P＞0.05），发生淋巴结转移、FIGO分期ⅡA期的CC患者CHN1、miR-205高表达率相较于未发生淋巴结转移、FIGO分期ⅠA~ⅠB期的CC患者明显升高（P＜0.05）。Spearman检验显示，CHN1、miR-205高表达与CC患者高危型HPV感染呈正相关（P<0.05）。经过3年随访，182例CC患者失访3例，3年总体生存率为78.21%。与CHN1、miR-205低表达组比较，CHN1、miR-205高表达组3年总体生存率明显降低（P＜0.05）。结论：CC组织CHN1、miR-205高表达与高危型HPV感染的发生、总体生存率降低有关，两者可能协同调控高危型HPV感染从而影响CC发生、发展和预后。

英文摘要:

Objective To study the relationship between the expression of microRNA (miR) -205 and α-chimeric protein (CHN1) in cervical cancer (CC) tissues and high-risk human papillomavirus (HPV) infection and prognosis. Methods 182 patients with CC admitted to Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2018 to February 2021 were selected as CC group, and 150 patients with cervical intraepithelial neoplasia (CIN) admitted to Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University during the same period were selected as CIN group and 150 patients with cervicitis were selected as cervicitis group. The high expression rate of CHN1, the relative expression of miR-205 and the positive infection rate of high-risk HPV were compared among three groups. The high expression rate of CHN1 and the relative expression of miR-205 in CC patients with different high-risk HPV infection types and viral load were compared. The high expression rates of CHN1 and miR-205 in CC patients with different clinicopathological features were compared. The correlation between the expression of CHN1 and miR-205 and high-risk HPV infection in CC patients were analyzed by Spearman test. CC patients were followed up for 3 years, the 3-year overall survival rate of CC patients in CHN1 and miR-205 low and high expression groups were analyzed by Kaplan-Meier method and Log-Rank test. Results The high expression rate of CHN1, the relative expression of miR-205 and the positive infection rate of high-risk HPV in CC group were higher than those in CIN group and cervicitis group, and the high expression rate of CHN1, the relative expression of miR-205 and the positive infection rate of high-risk HPV in CIN group were higher than those in cervicitis group (P<0.05). Among 166 CC patients with high-risk HPV positive infection, the higher the viral load, the higher the CHN1 high expression rate and the higher the relative expression of miR-205, and the high expression rate of CHN1 and the relative expression of miR-205 in multiple infection were significantly higher than those in single infection (P<0.05). There was no statistical difference in the high expression rate of CHN1 and miR-205 among CC patients with different age, tumor diameter, pathological type and differentiation degree (P>0.05), the high expression rate of CHN1 and miR-205 in CC patients with lymph node metastasis and FIGO stage IIA were significantly higher than those in CC patients without lymph node metastasis and FIGO stage ⅠA~ⅠB (P<0.05). Spearman test showed that, the high expression of CHN1 and miR-205 were positively correlated with high-risk HPV infection in CC patients (P<0.05). 3 years after follow-up, 3 of 182 CC patients were lost to follow-up, and the 3-year overall survival rate was 78.21%. Compared with low expression group of CHN1 and miR-205, the 3-year overall survival rate in high expression group of CHN1 and miR-205 was significantly lower (P<0.05). Conclusion The high expression of CHN1 and miR-205 in CC tissues is related to the occurrence of high-risk HPV infection and the decrease of overall survival rate, which may synergistically regulate high-risk HPV infection to affect the occurrence, development and prognosis of CC.

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