p16INK4a蛋白在胸腹水细胞蜡块中的表达及临床意义  

Expression and clinical significance of p16INK4a in paraffin-embedded specimens from ascites and pleural effusion

作　　者：郭睿[1] 李曼[1] 赵世平 黄小钟[1] 金雪媛 杨军[1] GUO Rui;LI Man;ZHAO Shiping;HUANG Xiaozhong;JIN Xueyuan;YANG Jun(Department of Pathology,Second Affiliated Hospital of Xi＇an Jiaotong University,Xi＇ an 710004,China)

机构地区：[1]西安交通大学第二附属医院病理科,西安710004

出　　处：《山西医科大学学报》2018年第8期958-962,共5页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目(NSFC30872403);教育部新世纪优秀人才计划(NCET-10-0647);教育部"长江学者和创新团队发展计划"创新团队(IRT1171)

摘　　要：目的检测p16INK4a蛋白在胸腹水细胞蜡块中的表达水平,并探讨其临床意义。方法胸腹水细胞蜡块标本77例,其中恶性60例,良性17例,通过免疫组化的方法检测p16INK4a蛋白在其中的表达水平。结果在恶性胸腹水样本中,p16INK4a蛋白阳性(染色强度≥++)表达率高达83.33%,p16INK4a阴性表达率为16.67%,与良性病变相比较差异具有统计学意义(P<0.05)。以p16INK4a中等染色强度(≥++)为界值,p16INK4a作为恶性肿瘤分子标志的敏感性为75.76%、特异性为64.29%、阳性预测值为83.33%、阴性预测值为52.94%;同时,p16INK4a在肺癌胸腹水样本中的敏感性为76.47%、特异性为69.23%、阳性预测值为86.67%、阴性预测值为52.94%,在其他恶性肿瘤胸腹水样本中的敏感性为75.00%、特异性为60.00%、阳性预测值为80.00%、阴性预测值为52.94%,二者差异无统计学意义(P>0.05)。结论 p16INK4a蛋白代偿性高表达是恶性胸腹水的免疫表型特征,可作为肿瘤分子靶标,适合用于良恶性胸腹水的诊断和鉴别诊断,有助于提高恶性胸腹水的阳性检出率。Objective To investigate the expression and its clinical significance of p16 INK4 a protein in paraffin-embedded specimens from ascites and pleural effusion.Methods Totally 77 cases of paraffin-embedded specimens from ascites and pleural effusion were collected,including 60 malignant tumor cases and 17 benign lesion cases.The expression of p16 INK4 a was detected by immunohistochemistry（IHC）.Results In malignant tumor cases,the positive rate of p16 INK4 a expression（≥ ＋ ＋） was 83.33%,significantly higher than that in benign lesion cases（P〈 0.05）.Using p16 INK4 a medium staining intensity（≥ ＋ ＋） as the boundary value of positive expression,the sensitivity,specificity,positive predictive value（PPV） and negative predictive value（NPV） of p16 INK4 a as a biomarker for malignant tumor were 75.76%,64.29%,83.33% and 52.94%,respectively.The sensitivity,specificity,PPV and NPV of p16 INK4 a were 76.47%,69.23%,86.67% and 52.94% for lung carcinoma,respectively,and 75.00%,60.00%,80.00%and 52.94% for the other kinds of malignant tumors.The results showed that there was no statistical difference in the clinical significance of p16 INK4 a between lung carcinoma and the other kinds of malignant tumor（P〉 0.05）.Conclusion The compensatory high expression of p16 INK4 a is an important immunophenotypic characteristic of malignant tumor cells in ascites and pleural effusion.So p16 INK4 a could be used as a biomarker to differentially diagnose the malignant and benign ascites and pleural effusion,and helps to improve the positive detection rate of malignant pleural effusion and ascites.

关 键 词：P16INK4A蛋白 胸腹水 细胞蜡块 免疫组织化学 肿瘤标志物 

分 类 号：R446[医药卫生—诊断学]