p16^(INK4A)、P14^(ARF)蛋白在宫颈鳞癌中的表达及意义

Expressions and Significance of p16^(INK4A) and p14^(ARF) Proteins in Squamous Carcinoma of the Cervix

目的:研究p16INK4A和p14ARF蛋白在各级宫颈病变中的表达特征和临床意义。方法:采用免疫组织化学S-P法对95例宫颈鳞癌(SCC)标本、80例宫颈上皮内瘤变(CIN)标本和45例正常宫颈标本进行p16INK4A和p14ARF蛋白的检测。结果:按正常宫颈-CINⅠ-CINⅡ-CINⅢ-宫颈鳞癌的顺序,p16INK4A及p14ARF的阳性率逐渐升高,具显著性差异(P<0.01),p16INK4A和p14ARF在各级宫颈病变中的表达呈正相关(r=1)。宫颈鳞癌组织中,p16INK4A、p14ARF在临床Ⅱ期中的阳性率(分别为98.3%、96.6%)均高于临床Ⅰ期的阳性率(分别为83.8%、78.4%),差异有显著意义(P1=0.025,P2=0.013);随着病理分级由Ⅰ级→Ⅲ级,p16INK4A、p14ARF的阳性率从低到高,呈正相关(r=1);p16INK4A、p14ARF与淋巴结转移无关(P>0.05)。结论:p16INK4A和p14ARF蛋白的阳性表达与宫颈疾病的严重程度密切相关,在宫颈鳞癌的形成及进展中起重要作用,p16INK4A和p14ARF蛋白基因有可能成为预测宫颈鳞癌发生及病程进展的生物学检测指标。

Objective： To study the expressions and clinical significances of p16^INK4A and p14^ARF proteins in squamous carcinoma of the cervix（SCC） and cervical intraepithelial neoplasia（CIN）. Methods： The expressions of p16^INK4A and p14^ARF proteins were detected in 95 SCC samples and 80 CIN samples by immunohistochemistry （S- P method）, and 45 normal cervix samples as control. Results： The portions ofpl 6^INK4A and p14^ARF -positive samples increased in the following row： normal cervix - CIN Ⅰ - CIN Ⅱ - CIN Ⅲ -SCC,which had significant differences （P〈0.01）. The positive correlations were found between the p16^INK4A and the pl 4ARF expressions in consecutive cervical lesions （r=1）. Of the 95 samples analyzed from SCC patients, the positive expressions rates of p16^INK4A and p14^ARF in the groups of clinical stage Ⅱ （98.3% and 96.6%） were higher than those in the group of clinical stage Ⅰ （83.8% and 78.4%）. The expressions of p16^INK4A and p14^ARF were closely related to clinical stage （P1=0.025, P2=0.013）. We also noticed a positive correlation among the p16^INK4A expression, p14^ARF expression and histological grading in SCC （r=1）.The positive expression rates of pI6^INK4A and p14^ARF were not associated with the lymph node metastasis （P〉0.05）. Conclusion： The positive expressions of pI6^INK4A and p14^ARF were closely related to consecutive cervical lesions, p16^INK4A and p14^ARF might play roles in the formation and progression of cervical cancer.The expression levels of p16^INK4A and p14^ARF might be referred as markers of squamous carcinoma of the cervix.