宫颈腺癌中IMP3和p16^(INK4a)的表达及意义  

Expression of insulin like growth factor-II mRNA binding protein 3 and p16^(INK4a) and their significance in adenocarcinoma of uterine cervix

作　　者：张著学[1] 易韦[1] 文安智[1] 刘纪昀[1] 杨迎春[1] 吴倩[1] 

机构地区：[1]贵州省人民医院病理科,贵阳550002

出　　处：《诊断病理学杂志》2015年第4期228-232,共5页Chinese Journal of Diagnostic Pathology

基　　金：贵州省科技厅项目[黔科合LS字(2012)020号];贵州省卫生厅项目[黔卫发(2012)84号]

摘　　要：目的探讨宫颈腺癌中胰岛素样生长因子ⅡmRNA结合蛋白(IMP3)和p16INK4a蛋白的表达及意义。方法运用免疫组化SP法观察IMP3和En Vision法观察p16INK4a在宫颈25例良性腺上皮(BEG)、10例原位腺癌(AIS)和50例浸润性腺癌(ECA)中的表达,同时随机选取IMP3不同程度阳性表达病例25例进行IMP3 mRNA原位杂交检测。结果 IMP3在BEG、AIS和ECA中阳性率分别为16%(4/25)、90%(9/10)和78%(39/50),差异显著(P<0.01);p16INK4a阳性率分别为0(0/25)、100%(10/10)和82%(41/50),差异显著(P<0.01)。ECA中,IMP3和p16INK4a在浆液性腺癌中的阳性率(均为100%,3/3)均高于宫颈型(76.19%,32/42和83.33%,35/42)和子宫内膜样型(80%,4/5和60%,3/5);腺癌中,IMP3在高分化腺癌与中-低分化腺癌中的阳性率比较差异显著(P<0.05)。IMP3和p16INK4a分别在不同年龄、组织学类型及FIGO分期中表达差异均不显著(P>0.05)。ECA中,IMP3和p16INK4a共同阳性率为64%(32/50),阴性率4%(2/50),两者表达的关联性较低(Kappa值为0.002,P>0.05)。结论 IMP3和p16INK4a在宫颈腺上皮的良、恶性病变鉴别诊断中有重要参考价值,IMP3表达与肿瘤分化程度相关;IMP3和p16INK4a联合运用可辅助临床ECA的诊断。Objective To investigate the expression and significance of insulin like growth factor-Ⅱ mRNA binding protein 3 （IMP3） and p16^INK4a in adenocarcinoma of the uterine cervix. Methods Immunohistochemical method was used to detect the expression of IMP3 （SP method） and p16^INK4a （EnVision） in 25 cases of benign endocervieal glands （BEG） , 10 cases of endocervical adenocarcinoma in situ （AIS） and 50 eases of endocervical adenocarcinoma （ECA）. To further assess the level of IMP3 protein expression, in situ hybridization detection of IMP3 mRNA was performed in 25 cases of ECA with IMP3 varying expression. Results The positive rates of IMP3 were 16. 00% （4/25） in BEG, 90% （9/10）in AIS and 78.00% （39/50） in ECA, respectively. The positive expression of p16^INK4a was 0% （0/25） in BEG, 100% （10/10）in AIS and 82. 00% （41/50）in ECA, respectively. The positive expression rate of IMP3 and p16^INK4a in serous adenocarcinoma （both 100% , 3/3） was higher than that in the cervical type （76. 19% , 32/42 and 83.33% , 35/ 42） and endometrial type （ 80. 00% , 4/5 and 60.00% , 3/5 ） adenocareinoma in all ECA cases. There was significant difference between well differentiated cases and moderately to poorly differentiated cases （ P 〈 0.05 ）. A significant difference of IMP3 and p16^INK4a expression was not shown between different age, categories of cell type and FIGO stage （P 〉 0. 05 ）. Commonly, positive expression of IMP3 and p16^INK4a was 64% （32/50）, and negative expression was 4% （2/ 50） in all ECA cases. Kappa value of Chi-square correlation analysis was 0. 002, P = 1.00. Conclussion IMP3 and p16^INK4a are important proteins in the differential diagnosis of benign vs. malignant cervical glandular epithelial lesions; IMP3 expression in ECA is correlated with tumor＇s differentiation. The detection of IMP3 and p16^INK4a is helpful for the diagnosis of ECA.

关 键 词：子宫颈 腺癌 原位腺癌 IMP3 P16 免疫组化 

分 类 号：R737.33[医药卫生—肿瘤]