P16^(INK4A)在宫颈癌及癌前病变脱落细胞中表达的临床意义及其与HPV16、18型的关系

Study on the expression of P16~INK4A in the cytological specimen of cervical carcinoma and precancerous diseases and it's relationship to HPV types 16 and 18.

目的:观察p16IND4A能否作为宫颈癌、宫颈癌前病变标志物及其与HPV16、18型的关系。方法: 采用免疫组织化学S-P方法,检测p16IND4A在宫颈脱落细胞中表达。同时,采用FQ-PCR技术检测HPV16、18 型DNA。结果:9例宫颈鳞状细胞癌P16INK4A表达均为阳性;45例LSIL,44例P16INK4A表达为阳性,仅1例为阴性;38例的HSIL均为阳性;30例中ASC有10例阳性,20例正常宫颈及40例慢性宫颈炎,P16INK4A染色均为阴性。HPV16、18型DNA阳性率分别为8/9、31.1%、68.4%、33.3%。40例慢性宫颈炎HPV16、18 型DNA阳性1例,正常宫颈细胞未检测出HPV16、18型DNA。结论:HPV16、18型DNA阳性率及阳性标本拷贝数愈高,P16INK4A表达的强度愈强。p16INK4A有望成为宫颈癌前病变诊断标志物。

Objective： To investigate whether P16^INK4A can be an indicator in the diagnosis of cervical carcinoma and precancerous diseases. Method： Immunohistochemistry （SP method） was employed to detect the expression of P16^INK4A in the cytology specimen of cervix. And FQ-PCR technology was used to detect the expression of HPV types 16 and 18 DNA. Results： P16^INK4A positive was found in all 9 cases of cervical squamous carcinoma and 38 cases of HSIL. Among 45 case of LSIL, 44 cases were found P16^INK4A positive. While in 30 cases of ASC only 10 were found P16^INK4A positive and none of 20 cases of normal cervix and 40 cases of chronic cervicitis were found positive. The positive rates of HPV types 16 and 18 DNA expression were 88.9%, 31.1%, 68.4% and 33.3% in squamous cervical carcinoma, LSIL, HSIL and ASC, respectively. HPV types 16 and 18 DNA positive was found in only one case of chronic cervicitis and none of normal cervix was found positive. The higher the positive rates and copies of HPV types 16 and 18 DNA expression, the stronger the expression of P16^INK4A was found. Conclusion： P16^INK4A may become a useful indicator in the diagnosis of cervical precancerous diseases.