P16、P53蛋白和HPV联合检测在宫颈疾病鉴别诊断中的价值  

Value of combined detection of P16 protein,P53 protein and human papillomavirus for differential diagnosis of cervical diseases

作　　者：杨静[1] 陶琨[1] 杨华[1] 郭振华[1] 谈振宇[1] 左绪磊[2] 

机构地区：[1]上海市长宁区中心医院病理科,200336 [2]复旦大学附属金山医院妇产科

出　　处：《中国妇幼保健》2012年第9期1388-1391,共4页Maternal and Child Health Care of China

摘　　要：目的:探讨P16、P53蛋白联合人乳头状瘤病毒(HPV)检测在宫颈病变鉴别诊断中的价值。方法:收集上海市长宁区中心医院病理科2006～2010年行阴道镜活检的患者360例,根据组织学诊断结果分为6组,采用免疫组化Elivision两步法检测了P16、P53蛋白表达,并且进行了HPV定量及分型检测。结果:P16蛋白在正常组罕见表达,而病变组仅表达在病变部位,高级别病变组与低级别病变组表达比较,差异有统计学意义(P<0.05);P53蛋白在正常组与病变组均有表达,低级别病变组表达弱阳性,高级别病变组表达强阳性,差异有统计学意义(P<0.05)。HPV定量检测显示病毒载量在各病变组的差异无统计学意义(P>0.05),而分型检测表明,HPV16是病变组中感染最多的亚型,且随着病变加重,感染率增加(P<0.05)。相关性分析显示,HPV感染与P16阳性表达(r=0.99)、P53强阳性表达(r=0.74)存在正相关。P16对高级别上皮内病变的诊断效能与HCⅡ接近。结论:HPV与P16、P53蛋白共同作用参与了宫颈癌的发生发展,P16蛋白联合HPV定量或分型检测对于宫颈高级别上皮内病变具有一定的鉴别诊断价值。To explore the value of combined detection of P16 protein, P53 protein and human papillomavirus （HPV） for differential diagnosis of cervical diseases. Methods： A total of 360 patients who received biopsy under eolposcope in the hospital from 2006 to 2010 were collected, then they were divided into six groups according to histological diagnostic results, Elivision twostep method was used to detect the expression levels of P16 protein and P53 protein, HPV quantification and HPV typing detection were performed. Results： P16 protein barely expressed in normal group, and it only expressed in lesion site of lesion group, there was signif- icant difference in the expression of P16 protein between high grade lesion group and low grade lesion group （P 〈0. 05） . 1＇53 protein ex- pressed in normal group and lesion group, there was significant difference in the expression of P53 protein between high grade lesion group and low grade lesion group （P 〈 0. 05） . HPV quantification detection showed that there was no significant difference in HPV viral load among different lesion groups （P 〉 0. 05 ） . The results of typing detection showed that HPV 16 was the most common infection subtype in lesion group, the infection rate of HPV 16 increased with aggravation of the disease （P 〈0.05） . The resuhs of correlation analysis showed that there was positive correlation between HPV infection and positive expression of P16 protein （γ = 0. 99）, strongly positive expression of P53 protein （γ = 0. 74） . The diagnostic efficacy of P16 protein for high grade intraepithelial lesion was similar to HC II. Conclusion： HPV, P16 protein, and P53 protein participate in the occurrence and development of cervical cancer, P16 protein combined with HPV quantification or HPV typing detection has a ce^in value for differential diagnosis of high grade cervical intraepithelial lesions.

关 键 词：P16 P53 HPV 联合检测 宫颈疾病 

分 类 号：R711.74[医药卫生—妇产科学]