p16^(INK4a)在宫颈细胞学鳞状上皮内瘤变中的意义  

Diagnostic value of p16^(INK4a)in squamous intraepithelial lesion in gynecologic cytology

作　　者：梅平[1] 刘艳辉[1] 庄恒国[1] 骆新兰[1] 肖克林[2] 

机构地区：[1]广东省人民医院病理科,广州510080 [2]深圳市宝安区妇幼保健院检验科

出　　处：《中华病理学杂志》2007年第8期521-523,共3页Chinese Journal of Pathology

摘　　要：目的探讨 p16^(INK4a)的表达在宫颈细胞学中鳞状上皮内瘤变中的意义及其与人乳头状瘤病毒(HPV)型别之间的关系。方法对88例经活检证实的液基细胞学标本[包括20例慢性宫颈炎、18例低度鳞状上皮内瘤变(LSIL)、34例高度鳞状上皮内瘤变(HSIL)及16例鳞状上皮细胞癌(SCC)],分别用免疫细胞化学(EnVision 方法)检测其 p16^(INK4a)的表达,并对所有标本用聚合酶链反应(PCR)方法检测 HPV 型别(包括 HPV16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、6、11、42、43及44型)。结果 p16^(INK4a)在慢性宫颈炎组呈阴性,在 LSIL、HSIL 及 SCC 组的表达率分别为27.8%、100%及100%,LSIL、HSIL 及 SCC 组 p16^(INK4a)的表达均显著高于慢性宫颈炎组(P<0.01);p16^(INK4a)在高危型 HPV 感染组的表达率(96.4%)显著高于低危型 HPV 感染组(7.7%),差异有统计学意义(t=4.32,P<0.01)。结论 p16^(INK4a)是一种敏感性较高,特异性较好的标记物,可以识别与高危型 HPV有关的非典型鳞状上皮细胞。Objective To study the diagnostic value of p16^INK4a in squamous intraepithelial lesion in gynecologic cytology and its relationship with types of human papillomavirus （HPV）. Methods 88 liquid-based gynecologic cytology cases with histologic correlation, including 20 cases of cervicitis, 18 cases of low- grade squamous intraepithelial lesion （LSIL）, 34 cases of high-grade squamous intraepithelial lesion （HSIL） and 16 cases of squamous cell carcinoma （SCC）, were enrolled into the study. Immunocytochemistry for p16^INK4a protein and polymerase chain reaction-based HPV DNA testing （for HPV types 16, 18, 31,33, 35, 39, 45, 51,52, 53, 56, 58, 59, 66 and 68, as well as HPV types 6, 11,42, 43 and 44） were performed. Results The rate of expression of p16^INK4a protein was 0, 27. 8% , 100% and 100% in the cervicitis group, LSIL group, HSIL group and SCC group, respectively. The expression was significantly higher in the latter 3 groups than that in the cervicitis group （ P 〈 0. 01 ）. Besides, the expression was significantly higher in cases associated with high-risk HPV genotypes （96. 4% ） than in cases associated with low-risk HPV genotypes （7.7%）. Conclusion p16^INK4a is a valuable biomarker for detection of HPV-related dysplastic squamous cells, with high sensitivity and specificity.

关 键 词：宫颈上皮内瘤样病变 蛋白质P16 细胞学技术 乳头状瘤病毒 人 

分 类 号：R737.33[医药卫生—肿瘤]