宫颈活组织病理检查及免疫组化P16蛋白检测在高危型人乳头瘤病毒阳性病人中的意义  

Clinical significance of cervical biopsy and P16 protein detection in patients with high-risk human papilloma virus positive

作　　者：王海玮[1] 柴丽丽[1] 杨国青[1] 陈燕[1] WANG Haiwei;CHAI Lili;YANG Guoqing;GHEN Yan(Department of Pathology,Xi′an Central Hospital,Xi′an,Shaanxi 710003,China)

机构地区：[1]西安市中心医院病理科,陕西西安710003

出　　处：《安徽医药》2019年第3期495-498,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的评估高危型人乳头瘤病毒(HPV)阳性病人宫颈做活组织病理检查及P16蛋白检测的意义及价值。方法收集在西安市中心医院妇科门诊进行宫颈薄层液基细胞学和第二代杂交捕获法(HC2)二联筛查的病人资料,对其中226例HPV阳性病人随后进行宫颈活检及免疫组化P16蛋白联合检测。结果 226例HPV阳性病人中,宫颈活检诊断为炎症/萎缩、低级别上皮病变、高级别病变分别为73、98、55例,P16蛋白(+～+++)的表达率分别为35.6%(26/73),83.7%(82/98)和100%(55/55)。P16蛋白表达在炎症/萎缩组、低级别病变组及高级别病变组间差异有统计学意义(χ~2=158.29,P<0.001);三组病变间P16蛋白表达的两两比较,均差异有统计学意义(P<0.001)。结论 HC2法检测高危型HPV可作为临床宫颈病变筛查的常规手段,高危型HPV阳性病人应及时行病理活检,其与P16检测的联合应用将大大提高诊断的正确率。Objective To investigate the clinical significance of cervical biopsy and P16 protein detection in patients with high-risk human papilloma virus positive.Methods Patients who had received a dual screening with TCT and hybrid captureⅡ(HC-2)were analyzed.Expression of P16 protein was detected by immunohistochemical staining in 226 specimens of patients who were infected by HR-HPV.Kruskal Wallis test was used.Results Among the 226 patients,73,98,55 cases were diagnosed with inflammation/atrophy,a low level lesions and high level lesions,respectively.The expression rate of P16 protein(+-+++)in three groups respectively was 35.6%(26/73),83.7%(82/98)and 100%(55/55).There was a statistical difference in expression of P16 protein in the inflammation/atrophy,a low level lesions and high level lesions(χ^2=158.29,P<0.001).The expression of P16 protein was also significant difference among the three groups(P<0.001).Conclusions HR-HPV test is a valuable diagnosing technique.Biopsy should be used in patients with high-risk papilloma virus positive and P16 protein can be used as assistant marker in cervical intraepithelial neoplasma.

关 键 词：人乳头瘤病毒 宫颈活检 杂交捕获法 P16蛋白 

分 类 号：R737.33[医药卫生—肿瘤]