P16 INK4a蛋白及人乳头瘤病毒检测对宫颈癌前病变的预测价值  

Value of Immunocytochemical Staining of P16 INK4a Protein Combined with Human Papillomavirus Test for the Detection of Cervical Intraepithelial Neoplasia

作　　者：金艳[1] 曹树军[1] 杨道华[2] 施华珍[1] 钱金风[1] 

机构地区：[1]上海交通大学医学院附属第一人民医院松江分院妇产科,上海市201600 [2]上海交通大学医学院附属第一人民医院松江分院病理科,上海市201600

出　　处：《中国全科医学》2012年第29期3368-3370,共3页Chinese General Practice

基　　金：上海市松江区医学领先专业建设资助项目(05-Ⅰ-04);上海市松江区科技攻关项目

摘　　要：目的探讨P16 INK4a蛋白及人乳头瘤病毒(HPV)DNA对检测宫颈癌前病变的预测价值。方法收集2008年11月—2011年10月在上海交通大学医学院附属第一人民医院松江分院经细胞学筛查、阴道镜活检、组织病理学诊断为宫颈上皮内瘤变(CIN),并根据病变程度和患者意愿行宫颈锥切治疗的705例患者作为研究对象。分析P16 INK4a蛋白及HPV DNA检测对疾病的预测价值。结果 P16 INK4a蛋白阳性率在CINⅢ中高于HPV DNA阳性率(χ2=8.78,P<0.05),且P16 INK4a蛋白的阳性率与病变程度呈正相关(r=0.258,P<0.05),而HPV病毒阳性率与病变程度呈负相关(r=0.530,P<0.05)。结论 P16 INK4a蛋白比HPV DNA对检测CINⅢ具有更高的敏感性,所以HPV DNA联合P16 INK4a蛋白检测对CIN有更高的预测价值。Objective To evaluate the value of immunocytochemical staining of P16 INK4a protein combined with hu- man papillomavirus （ HPV ） test for detecting cervical intraepithelial neoplasia （ CIN ）. Methods Totally 705 patients with pathologically confirmed CIN in our hospital from November 2008 to October 2011 were enrolled in this study. We made a retro- spective study of the clinical and pathological data by immunocytochemical staining of P16 INK4a protein combined with HPV test. Results The sensitivity of the positive rate of P16 INK4a in high - grade CIN was significantly higher than that of HPV DNA test （ X2 = 20. 642, P 〈 0.05 ）. The positive rate of P16 INK4a protein staining was positively correlated with the pathologicdegree of lesions （X2 = 38.432, P 〈 0. 05 ）, while the positive rate of P16 INK4a test was positively correlated with the patholog- ic degree （ r = 0. 2580, P 〈 0. 05 ） the positive rate of HPV DNA test was negatively correlated with the pathologic degree （ r = - 0. 530, P 〈 0. 05 ）. Conclusion The immunocytochemical staining of p16 INK4a protein has a higher sensitivity than HPV DNA test in detecting high grade CIN, and therefore it, when combined with HPV DNA test, has a high predictive value for CIN.

关 键 词：宫颈上皮内瘤样病变 治疗 人类乳头病毒 P16 INK4a蛋白 

分 类 号：R711.74[医药卫生—妇产科学]