HPV L1壳蛋白与p16^(INK4a)的免疫组化检查在宫颈病变诊断中的应用  

The clinical application of the combination expression of HPV L1 capsid protein and p16^(INK4a) in cervical lesions

作　　者：姜晓曼[1,2] 黄民主[1] 李成华[3] 郑宝文[2] 张志魁[2] 吴心音[1] 李洪波[2] 

机构地区：[1]中南大学公共卫生学院,长沙410078 [2]广州金域医学检验中心,广州510330 [3]郴州市疾病预防控制中心,湖南郴州423000

出　　处：《临床检验杂志》2010年第1期66-67,71,共3页Chinese Journal of Clinical Laboratory Science

摘　　要：目的检测宫颈上皮病变过程中HPV L1壳蛋白和p16INK4a蛋白的表达,探讨二者联合在宫颈病变诊断中的应用价值。方法用免疫细胞化学方法检测169例不同级别的宫颈液基细胞学标本中HPVL1壳蛋白和p16INK4a蛋白的表达,并与组织病理学检查结果比较。结果随着宫颈活检病理分级升高,HPV L1壳蛋白阳性[L1(+)]率降低(P<0.01),p16INK4a阳性[p16(+)]率升高(P<0.01)。HPVL1壳蛋白阳性率与病理分级呈负相关(rs=-0.436,P<0.01);而p16INK4a阳性率与病理分级呈正相关(rs=0.459,P<0.01)。在宫颈上皮内瘤变(CIN)CIN1、CIN2、CIN3及鳞状细胞癌(SCC)中,L1(+)/p16(-)的表达率分别为19.18%、2.44%、0.00%、0.00%,L1(-)/p16(+)表达率分别为30.14%、75.61%、92.86%、100.00%。L1、p16INK4a、L1(-)/p16(+)在CIN1的表达与CIN2、CIN3、SCC比较,差异均具有统计学意义(P<0.01)。结论HPV L1壳蛋白、p16INK4a均可作为诊断宫颈病变程度的生物学标志;而HPV L1壳蛋白联合p16INK4a不仅能够预测宫颈病变的程度,而且有利于对CIN1患者的随访,可为宫颈癌早期诊断提供新的指标。Objective This study aimed to detect the expression of HPV L1 capsid protein and p16^INK4a in cervical lesions, and to evaluate the diagnostic value of the combination of HPV Li eapsid protein and p16^INK4a. Methods The expression of HPV L1 capsid protein and p16^INK4a was detected with immunochemical method in liquid-based cervical cytology specimens with different cervical lesions. The results of immunoehemical tests were compared with the biopsy review. Statistical analysis was performed by χ^2 test and Spearman＇s rank correlation analysis. Results L1 expression decreased （P 〈0.01 ） but p16^INK4a expression increased （P 〈 0.01 ） with the increase in pathological lesions. The severity of cervical lesions was negatively correlated with HPV L1 capsid expression （ rs = -0.436, P 〈0.01 ）, but positively correlated with p16^INK4a expression （r = 0. 459, P 〈 0.01 ）. The relation of L1 capsid and p16^INK4a , L1 （ ＋ ）/p16（ - ） cases represented 19.18% of CIN1, 2.44% of CIN2, and none of CIN3 or SCC, whereas L1 （ - ）/p16 （ ＋ ） cases represented 30.14% of CIN1, 75.61% of CIN2, 92.86% of CIN3, and 100.00% of SCC. The expression rates of HPV L1 capsid protein, p16^INK4a and L1 （ - ）/p16 （ ＋ ） in CIN2, CIN3, and SCC were statistically different from those in CIN1 （ P 〈 0.01 ）. Conclusions HPV L1 capsid protein and p16^INK4a are biomarkers of early diagnosis for cervical lesions. The combination of L1 capsid protein and p16^INK4a can predict the severity of cervical lesions. The combination of L1 capsid protein and p16^INK4a can provide a new indictor for early diagnosis for cervical cancer.

关 键 词：L1壳蛋白 P16^INK4A 生物学标志 宫颈病变 免疫组织化学 

分 类 号：R392.11[医药卫生—免疫学]