高危型HPV负荷量和p16^(INK4A)蛋白监测评估宫颈锥切术治疗CIN  

Significance of High-risk Human Papillomavirus(HPV) Detection and p16^(INK4A) Protein Expression in Predicting Residual Disease or Recurrence After Cervical Conization for Cervical Intraepithelial Neoplasia

作　　者：王华[1] 蔡红兵[2] 郭广林[1] 

机构地区：[1]湖北医药学院附属襄阳医院,襄阳市第一人民医院 [2]武汉大学中南医院,湖北省肿瘤生物学行为重要实验室,湖北省肿瘤临床医学研究中心,湖北襄阳441100

出　　处：《肿瘤学杂志》2012年第9期700-703,共4页Journal of Chinese Oncology

摘　　要：[目的]评价高危型人乳头状瘤病毒HPV负荷量的检测和p16INK4A蛋白的表达在预测宫颈上皮内瘤变(CIN)宫颈锥切术后残存病变或复发中的意义。[方法]回顾性分析142例2008年10月至2010年12月因CIN行宫颈锥形切除术治疗患者的临床资料。所有患者均于宫颈锥形切除术前6个月以内和术后6～12个月进行HPV负荷量检测,并采用免疫组化方法检测HPVDNA阳性患者宫颈细胞中p16INK4A蛋白表达。[结果]宫颈锥切术前,随着CIN级别的上升,HPV负荷量以及p16INK4A蛋白表达均明显增强(P<0.05)。但在宫颈锥切术后,HPV负荷量和p16INK4A蛋白表达明显降低,宫颈锥切术前和术后两者之间差异有统计学意义(P<0.05)。[结论]HPV负荷量持续增高和p16INK4A蛋白持续呈强阳性是宫颈锥切术后发生残存病变或复发的高危因素,在监测HPV负荷量的同时检测p16INK4A蛋白的表达,对判断宫颈锥切术后发生残存病变或复发有重要意义。[Purpose] To evaluate the significance of highrisk HPV detection and p16INX4A protein expression in predicting residual disease or recurrence after cervical conization for cervical in traepithelial neoplasia （CIN）. [Methods] A retrospective study was performed in 142 patients who underwent conization from October 2008 to December 2010. All patients accepted highrisk HPV loading detection within six months before cervical conization and six to twelve months after cervi cal conization. In addition,pl6INK4A were measured by immunohistoehemisty staining in 88 positive samples with HPV infection. [Results] The highrisk HPV loading increased along with CIN grades became higher before cervical conization,and the same situation existed between the ex pression of p16INK4A and CIN grades. However,the highrisk HPV loading and the expression of p 16INK4A markedly decreased after cervical conization. There were statistical differences before and after cervical conization （P〈0.05）. [Conclusion] The increase of highrisk HPV loading and the strengthened expression of p16INK4A are high risk factor for residual disease or recurrence after cer vical conization for CIN. Detection of highrisk HPV and p16INK4A expression at one time might be an effective method to predict residual disease or recurrence.

关 键 词：宫颈上皮内瘤变 人乳头状瘤病毒 P16INK4A蛋白 宫颈锥切 

分 类 号：R737.33[医药卫生—肿瘤]