P16和P53在宫颈细胞学不典型鳞状细胞不除外上皮内高度病变中辅助标记的意义  

The significance of P16 and P53 as assistant biomarkers in diagnosis of ASC cannot exclude HSIL by liquidbased cervical cytology

作　　者：杨琴[1] 梁建芳[2] 郑绘霞[2] 肖虹[2] 武丽娜[2] 刘聪[2] 白淘[2] 赵玉泽[3] 赵宏伟[4] 

机构地区：[1]山西省人民医院病理科 [2]山西医科大学第一医院病理科,太原030001 [3]山西医科大学儿科系 [4]山西省肿瘤医院妇科

出　　处：《中国药物与临床》2011年第6期630-633,共4页Chinese Remedies & Clinics

基　　金：山西省青年科技研究基金(2009021044-2)

摘　　要：目的评价P16和P53在宫颈液基细胞学诊断宫颈细胞学不典型鳞状细胞不除外上皮内高度病变(ASC-H)中辅助检测的标记意义。方法对59例ASC-H患者分别进行P16、P53免疫组织化学(IHC)检测、聚合酶链反应(PCR)-反向点杂交法进行人乳头瘤病毒(HPV)分型和阴道镜检查及活检,分析其结果之间的关系。结果 59例ASC-H中,P16、P53阳性者主要为鳞状上皮内高度病变(HSIL)及以上病变,包括28例HSIL和5例活检结果为宫颈鳞状细胞癌(SCC)的病例;随着宫颈病变级别的上升,P16、P53阳性率增高;35例高危型HPV阳性均为HSIL及以上病变,对ASC-H患者HSIL的敏感性及阴性预测值均为100%。结论 ASC-H高度提示高级别的宫颈病变存在;P16、P53的IHC结果与HPV分型检测结果具有良好的一致性,均可提示ASC-H患者应进一步行阴道镜检查及活检;但P16、P53的IHC检测更加方便、快速。Objective To explore the significance of P16 and P53 as assistant biomarkers in diagnosis of ASC cannot exclude HSIL （ASC-H） by liquid-based cervical cytology.Methods Fifty-nine ASC-H patients were performed immunohistochemistry （IHC） of P16 and P53,PCR-reverse dot blot for classification of human papillomavirus （HPV）,colposcopic examination and biopsy.The correlation among the results was then analyzed.Results Of the 59 ASC-H patients,the rates P16 and P53 positive expressions were mainly found in high grade squamous intraepithelial lesions （HSIL） or over,including 28 cases of HSIL and 5 cases of squamous carcinoma （SCC）.Along with the elevated pathological rank of cervicitis,the positive rates of P16 and P53 were increased.High-risk HPVs were all found positive in 35 cases of HSIL or over.Both sensitivity and negativity predictive value of HSIL in ASC-H patients were 100%.Conclusion ASC-H highly indicates the existence of high grade-cervical lesion.There was a favorable consistency between the IHC results of P16 and P53 and HPV classification detective results,both of which could indicate that ASC-H patients should undergo the further colposcopic examination and biopsy.However,the IHC of P16 and P53 might be more convenient and faster.

关 键 词：蛋白质P16 蛋白质P53 乳头状瘤病毒 人 宫颈上皮内瘤样病变 液基细胞学检测 

分 类 号：R737.33[医药卫生—肿瘤]