宫颈上皮内瘤变与人乳头状瘤病毒感染及p16蛋白表达的研究  

Detection of human papillomavirus DNA and expression of p16 protein in cervical intraepithelial neoplasia

作　　者：武景波[1] 张杰[1] 李小静[1] 朱卫[1] 陈兰悦[1] 滕昊骅[1] 洪玉萍[1] 舒维清[1] 

机构地区：[1]复旦大学附属上海市第五人民医院病理科,上海200240

出　　处：《诊断病理学杂志》2008年第3期174-177,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨人乳头状瘤病毒(HPV)感染及p16蛋白表达在宫颈上皮内瘤变(CIN)诊断和分级中的意义。方法采用免疫组化EnVision法检测191例宫颈各类病变中的p16蛋白表达;通过聚合酶链反应(PCR)检测其中104例HPV16/18型及6/11型DNA感染率。结果191例标本中,p16蛋白表达率为73.3%,其中75%呈带状,25%呈点状。CINⅠ级p16蛋白表达率较宫颈上皮鳞化伴增生明显增加(P<0.01);CINⅡ～Ⅲ级p16蛋白表达率较CINⅠ明显增加(P<0.01)。104例HPVDNA检测病例中,HPV16/18型检出率为49%(51/104),HPV6/11型检出率为9.6%(10/104)。CINⅠ级HPV16/18型检出率较鳞化伴增生组明显增加(P<0.05);CINⅡ～Ⅲ级HPV16/18型检出率同CINⅠ差异不显著(P>0.05)。结论p16可以作为宫颈上皮鳞化伴增生与CINⅠ级、CINⅠ级与CINⅡ～Ⅲ级间鉴别诊断的标记物;HPV16/18感染与p16蛋白带状表达明显正相关。Objective To investigate the significance of human papillomavirus （HPV） infection and the potential role of p16 immunohistochemical expression in diagnosis and grading of cervical intraepithelial neoplasia （CIN）. Methods staining was used for detection of p16 protein expression in 191 various cervical lesions. In 104 of 191 eases, the presence of HPV-6/11 and 16/18 DNA was determined by PCR. Results In 191 various cervical lesions, the expression rate of p16 was 73.3%. In C1N I, p16 expression rate was significantly higher than squamous metaplasia coupled with hyperplasia （P 〈 0.01 ）; In CIN Ⅱ -Ⅲ, p16 expression rate was significantly higher than CIN Ⅰ （P 〈 0.01 ）. HPV16/18 DNA was present in 51 of 104 specimens （49.0%） and HPV6/11 DNA was present in 10 of 104 specimens （9.6%）. The frequency of HPV16/18 in CIN Ⅰ was signifieantly higher than squamous metaplasia coupled with hyperplasia （ P 〈 0.05） and no difference was observed between CIN Ⅰ and CIN Ⅱ - Ⅲ （ P 〉 0.05）. Conclusions p16 can be used as a surrogte marker to distinguish CIN Ⅰ from squamous metaplasia coupled with hyperplasia, as well as CIN Ⅰ from CIN Ⅱ - Ⅲ, which improves the results of histologic classification. A band-like pattern of p16 staining is strongly associated with HPV16/18 infection.

关 键 词：宫颈上皮内瘤变 人乳头状瘤病毒 P16 

分 类 号：R737.33[医药卫生—肿瘤]