P16^(INK4A)联合HPV L1壳蛋白检测在宫颈鳞状上皮内病变诊断中的应用  

Application of P16^(INK4A) Combined with HPV L1 Protein Detection in the Diagnosis of Cervical Squamous Intraepithelial Lesions

作　　者：潘琼慧[1] 郑翔[2] 何海珍[1] 朱雪燕[1] 胡仙清 朱雪琼[3] 

机构地区：[1]温州医科大学温州市第三临床学院,温州市人民医院妇产科,325000 [2]温州医科大学温州市第三临床学院,温州市人民医院病理科,325000 [3]温州医科大学附属第二医院妇产科

出　　处：《医学研究杂志》2017年第5期104-108,69,共6页Journal of Medical Research

基　　金：浙江省温州市科技局基金资助项目(Y20140327)

摘　　要：目的初步探讨P16^(INK4A)联合HPV L1壳蛋白检测在宫颈鳞状上皮内病变诊断中的应用价值。方法选择在温州市人民医院就诊患者,收集69例宫颈鳞状上皮内病变标本,行P16^(INK4A)、HPV L1壳蛋白检测,分析P16^(INK4A)、HPV L1壳蛋白及P16^(INK4A)联合HPV L1壳蛋白在各级宫颈病变中的表达差异。结果 P16^(INK4A)在LSIL组、HSIL组、SCC组中的阳性率分别为45.5%、85.2%、100.0%。同LSIL组比较,P16INK4A在HSIL组及SCC组阳性率明显升高(P<0.01)。HPV L1壳蛋白在LSIL组、HSIL组、SCC组中的阳性率分别为63.6%、18.5%、0%,HPV L1壳蛋白在LSIL组中阳性率明显低于HSIL组及SCC组(P<0.01)。随着宫颈病变加重,P16+/L1-阳性率有升高趋势(P<0.01),P16-/L1+阳性率有下降趋势(P<0.01)。LSIL组中P16+/L1-阳性率明显低于HSIL组和SCC组(P<0.01),SCC组P16+/L1-阳性率较HSIL组有明显提高(P<0.05)。LSIL组中P16-/L1+阳性率明显低于HSIL组和SCC组(P<0.01)。P16+/L1-较P16^(INK4)、HPV L1壳蛋白单一检测筛查HSIL+特异性明显升高(P<0.01)。结论 P16^(INK4A)联合HPV L1壳蛋白有望成为诊断宫颈鳞状上皮内病变的有效指标。Objective To preliminary study the value of P16^INK4A combined with HPV L1 protein detection in the diagnosis of cervical squamous intraepithelial lesions. Methods A total of 69 gynecological outpatients that were found in Wenzhou People＇s Hospital were enrolled in the group. The expression of P16^INK4A and L1 HPV protein in 69 cases of cervical lesions were detected. The expression of P16^INK4A combined with HPV L1 in different levels of cervical lesions analyze was. Results The positive rate of P16^INK4A in the LSIL group, HISL group,and SCC group was 45.5%,85.2%,100%. Compared with the LSIL group, the positive rate of P16^INK4A in HSIL group and SCC group was significantly higher（P〈0.01）.The positive rate of HPV L1 protein in the LSIL group, HISL group,and SCC group was 63.6%,18.5%,0%. Compared with the LSIL group, the positive rate of HPV L1 protein in HSIL group and SCC group was significantly higher（P〈0.01）. With the increase of cervical lesions, the positive rate of P16＋/L1-expression was increased（P〈0.01）. The positive rate of P16-/L1＋expression was decreased （P〈0.05）. The positive rate of P16＋/L1-in LSIL group was significantly lower than that in HSIL and SCC group （P〈0.01）. There was statistical difference between HSIL group and SCC group（P〈0.05）. The positive rate of P16-/L1＋ in LSIL group was significantly lower than that in HSIL and SCC group （P〈0.01）. P16＋/L1-compared with P16^INK4A or L1（-）screening of HSIL＋ specificity was significantly higher （P〈0.01）. Conclusion P16^INK4A combined with HPV L1 protein is expected to be an effective marker for the diagnosis of cervical squamous intraepithelial lesions.

关 键 词：宫颈上皮内瘤变 周期素依赖激酶抑制剂p16 L1壳蛋白 HPV 

分 类 号：R71[医药卫生—妇产科学]