子宫颈癌组织中高危型人乳头状瘤病毒感染和P16^(INK4A)蛋白表达的检测

Detection of P16^(INK4A) expression and high-risk human papillomavirus HPV infection in cervical cancer tissue

目的:检测宫颈上皮癌变过程中高危型人乳头状瘤病毒(HR-HPV)感染和P16INK4A蛋白的表达。方法:应用免疫组织化学方法检测30例正常宫颈组织、23例宫颈上皮内瘤变Ⅰ级(CINⅠ)、26例CINⅡ、31例CINⅢ和22例浸润癌组织中P16INK4A蛋白的表达;用第二代杂交捕获法(HC-2)检测13种HR-HPVDNA。结果:正常宫颈、CINⅠ、CINⅡ、CINⅢ、浸润癌组织中,P16INK4A蛋白阳性表达率分别为6.67%、39.10%、88.50%、87.10%、90.90%,HR-HPV阳性率分别为30.00%、82.60%、80.80%、90.30%、95.50%,CINⅠ、Ⅱ、Ⅲ和浸润癌组织与正常宫颈组织相比,差异均有统计学意义(P<0.05或0.01)。等级相关分析结果显示,宫颈组织中HR-HPV阳性率与P16INK4A蛋白阳性表达率呈正相关(rs=0.564,P<0.01)。结论:HR-HPV致宫颈上皮恶性转化可能与P16INK4A蛋白过表达有关,P16INK4A和HR-HPV联合检测可提高对子宫颈癌及CIN的阳性预测值。

Aim： To detect P16^INK4A expression and high-risk human papillomavirus （HR-HPV） infection in cervical cancer and cervical intraepithelial neoplasias（CIN） tissue. Mothods：Immunohistochemical method was used to detect the expression of P16^INK4A in 30 cases of normal cervical tissues, 23 cases of CIN Ⅰ ,26 cases of CIN Ⅱ , 31 cases of CIN Ⅲ , and 22 cases of invasive squamous cell carcinomas of cervix（ISCC）. HR-HPV DNA of 13 types were detected by hybridcapture 2（HC-2） before biopsy and operation. Results： In normal, CIN Ⅰ , CIN Ⅱ , CINⅢ and ISCC tissue, the positive expression rates of P16^INK4A were 6.67% ,39. 1% , 88.50% , 87. 10% , 90.90% , respectively; and the positive rates of HR-HPV were 30.00% , 82.60, 80.80% , 90.30% , 95.50% , respectively. The positive expression rate of P16^INK4A and positive rate of HR-HPV in CIN Ⅰ , Ⅱ ,Ⅲ and ISCC tissue were higher than those in normal tissue （ P 〈0.05 or 0.01 ）. And the PI^INK4A positive expression was positively correlated with HR-HPV infection rate （r = 0. 564, P 〈 0.01 ）. ConclusiOn： P16^INK4A overexpression and HR-HPV infection may lead to the development of cervical dysplasia or cancer. The combined detection of HR-HPV and P16^INK4A will increase positive predict value of corvieal cancer.