P16^(INK4a)联合CK17在宫颈上皮内瘤变中的表达意义  

Combined Expression of P16^(INK4a) and CK17 in Cervical Intraepithelial Neoplasia and Its Clinical Value

作　　者：段志珍[1] 程艳香[1] 

机构地区：[1]武汉大学人民医院妇产科,湖北武汉430060

出　　处：《华南国防医学杂志》2014年第9期843-846,共4页Military Medical Journal of South China

基　　金：湖北省自然基金项目(2011ZRY139);湖北省卫生厅资助项目(2012Z-Y02);中国博士后资助项目(2011M500857)

摘　　要：目的研究p16INK4a联合CK17在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)中的表达情况,探索其临床意义。方法以导流杂交技术检测宫颈病变中高危型人乳头瘤病毒(high risk human papilloma virus,HRHPV)感染,用免疫组织化学方法分别检查CIN病变组织中p16INK4a和CK17表达,并分析HR-HPV病毒感染与p16INK4a及CK17的关联性。结果 1根据宫颈病理结果,将本组119例患者分为3组,其中A组43例,包括慢性宫颈炎及CINⅠ;B组71例,包括CINⅡ-Ⅲ;C组5例,包括宫颈癌。在A组中,HR-HPV感染率为51.2%(22/43),B组中,HR-HPV感染率为86.0%(61/71),在C组中,HR-HPV感染率为100%(5/5);2p16INK4a在宫颈炎、CIN、宫颈癌组织中的表达率分别为14.0%、63.8%、100%,表达率逐渐增高;而CK17分别为58.1%、22.5%、0%表达率逐渐降低。差异均有统计学意义(χ2=32.13,P<0.05;χ2=17.78,P<0.05)。3宫颈病变中,p16INK4a与CK17无相关性;p16INK4a的表达与HR-HPV病毒含量正相关(r=0.291,P=0.001),而CK17表达与HPV病毒含量负相关(r=-0.335,P<0.001)。结论p16INK4a与CK17的联合检测在宫颈病变的诊断中无明显意义,但均与HR-HPV感染相关的CIN的发生发展密切关系。Objective To investigate the expression of p16^INK4a combined with CK17 in cervical intraepithelial neo- plasia （CIN） and its clinical value.Methods Diversion hybrid technology was used to detect the HR-HPV infection in cer- vical lesions, and SP method was used to explore the combined expression of p16^INK4a and CK17 in different cervical le- sions. The correlation among HRHPV infection, p16^INK4a and CK17 was analyzed.Results According to cervical patholo- gy results, the patients were divided into three groups, including 43 women with chronic cervicitis,71 women with CIN Ⅱ-Ⅲ, 5 women with cervical cancer.The infection rates of HR-HPV in the three groups were 51.2%,86.0% and 100% respectively, and the expression rates of p16INKea were 14.0 %, 63.4%, 100 %. The expression rate of CK17 were 58.1%, 22.5 % and 0 %, which were significantly different among the three groups （χ2 = 32.13, 17.78, P 〈 0.05）. P16INK4a and CK17 had no correlation in cervical lesions but the expression of p16^INK4a was positively related to HPV （r = 0.291, P = 0.001 ） ,CK17 was negatively related to HPV （r = - 0.335,P〈0.001）.Conehtsion The combined detection of p16^INK4a and CK17 has no meaning in diagnosing cervical disease, but they play important roles in the process of HR-HPV infection induced CIN.

关 键 词：宫颈上皮内瘤变 P16INK4A 人乳头瘤病毒 

分 类 号：R711.74[医药卫生—妇产科学]