宫颈薄层液基细胞中P16ink4a的表达在宫颈癌筛查中的意义  

The significance in expression of protein p16 in liquid-based thinner cytology to cervical screening

作　　者：韩雪松[1] 王钫[1] 徐琳[1] 许妙玲[1] 

机构地区：[1]昆明医学院第一附属医院妇产科,云南昆明650031

出　　处：《中国实验诊断学》2011年第4期656-659,共4页Chinese Journal of Laboratory Diagnosis

基　　金：云南省教育厅科学研究项目(编号:07Y11213)

摘　　要：目的探讨肿瘤抑制基因P16ink4a的编码产物p16蛋白的表达在宫颈液基薄层细胞学(liquid based cytologi-cal test,LCT)筛查中的意义及作为宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)生物标志物的可行性和临床意义。方法选择96例HPV阳性的宫颈液基薄层细胞学剩余标本,制作液基薄片,利用SP免疫组化法检测LCT标本中p16蛋白,并与组织活检结果进行对照。结果 p16蛋白在宫颈细胞学诊断未见上皮内病变及癌变(NILM)、非典型鳞状上皮细胞(ASC)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)的阳性表达率分别为0(0/20)、38.9%(14/36),25.0%(5/20)、85.0%(17/20)。其中ASC及HSIL组的阳性率显著高于NILM组(P<0.05),而LSIL组与NILM组比较差异则无统计学意义(P>0.05)。与病理组织作对照,病检为慢性宫颈炎的病例中,有1例在LCT上p16蛋白表达阳性(2.70%,1/36);各级CIN中40例表达阳性(72.7%,40/55);5例SCC全部表达阳性(100.0%,5/5),且前两组阳性率差异有统计学意义(P<0.05)。结论 p16蛋白异常表达与CIN的发生有关,其可作为CIN的标志物,辅助细胞学筛查。Objective To evaluate the significance in expression of protein p16 which is the product of tumor-suppressing gene P16ink4a in liquid-based cytology to cervical screening and the confidence to be the biological marker of cervical intraepithelial neoplasia（CIN）.Methods SP immunohistochemistry detection of protein p16 was performed on 78 specimens remaining from liquid-based cytology which HPV detection was positive,and compared with the results of biopsy histology.Results In patients with cytological diagnosis of negative for intraepithelial lesion or malignancy（NILM）,atypical squamous cells（ASC）,low-grade squamous intraepithelial lesion（LSIL）,and high-grade squamous intraepithelial lesion（HSIL）,the positive rates of protein p16 were 0（0/20）、38.9%（14/36）,25.0%（5/20）、85.0%（17/20）,respectively.The positive rate in ASC and HSIL groups was significantly higher than NILM group（P0.05）.Whereas for LSIL group was not（P0.05）.Compared with the results of biopsy histology,one case was positive of protein p16 in chronic cervicitis group（2.70%,1/36）,40 cases in CIN（72.7%,40/55）,and 5cases in SCC（100.0%,5/5）.The difference in the positive rates between the first two groups（P0.05）.Conclusion The abnormal expression of protein p16 has connected with the development of CIN,which can become the maker of CIN to help cytology screening.

关 键 词：宫颈上皮内瘤变 免疫组化 P16蛋白 

分 类 号：R737.33[医药卫生—肿瘤]