p16和p15及PCNA在子宫颈癌组织中的表达及临床病理意义

Expressions and clinical significance of p16, p15 proteins and PCNA in uterine cervical carcinoma

目的:研究p16、p15蛋白及增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)在子宫颈癌中的表达特点,并探讨其与病理分级的关系。方法:应用免疫组织化学ElivisionTM二步法检测41例宫颈癌及30例正常宫颈组织中p16、p15及PCNA的表达情况,并结合病理分级进行分析。结果:1)p16和p15蛋白在宫颈癌组织的表达率分别为14·63%(6/41)和17·07%(7/41),明显低于在正常宫颈组织中的表达率100%(30/30)和96·67%(29/30),χ2=8·834,P=0·003;2)p16、p15蛋白阳性表达率与宫颈癌组织的病理学分级有关,p16、p15在宫颈癌Ⅰ级中的阳性表达率28·57%(4/14)、28·57%(4/14),明显高于Ⅱ级18·75%(3/16)、12·50%(2/16),χ2=6·069,P=0·014,也高于Ⅲ级9·09%(1/11)、9·09%(1/11),χ2=7·86,P=0·005;3)宫颈癌组织PCNA阳性表达率95·12%(39/41)及阳性细胞指数(47·97±8·69)%,均明显高于正常对照组的阳性表达率3·33%(1/30)及阳性细胞指数(3·56±0·53)%,χ2=10·773,P=0·001;并且与病理学分级存在相关性。结论:抑癌基因p16、p15的表达缺失在子宫颈癌中同时存在,p16、p15及PCNA检测对于研究宫颈癌的发生、发展和评估子宫颈癌恶性程度具有重要意义。

OBJECTIVE： To investigate the expressions of p16, p15 and proliferating cell nuclear antigen （PCNA） proteins in primary cervical carcinomas and its clinical significance. METHODS： The expressions of p15, p16 and PCNA proteins in 41 cases of cervical carcinomas and 30 cases of normal cervical tissues were detected by the supersensitive ElivisionTM immunohistochemical method. RESULTS： 1）p16 and p15 positive expression rates in cervical carcinomas [14. 63% （6/41） and 17. 07%（7/41）] were significantly lower than those in normal cervixes [100% （30/30） and 96.67%（29/30） X^2 =8. 834, P=0.003]; 2）p16 and p15 expressions were correlated with the differentiation state and pathologic grades, the positive expression rates of p16, p15 in the cervical carcinomas of grades I [28.57% （4/14）, 28.57% （4/14）] was significantly higher than those in the cervical carcinomas of grades Ⅱ [18.75%/00 （3/16）, 12.50% （2/16）,X^2 =6.069,P= 0.014,X^2=6.069,P=0.014], and grades Ⅲ [9.09%（1/11）, 9.09%（1/11）, X^2 = 7.86, P= 0.005]; 3） The positive rates [95. 12%（39/41）] and positive cells [（47.97±8.69）%] of PCNA in the cervical carcinomas were significantly higher than those in normal cervix [3.33%（1/30）, （3.56±0.53）%] ,X^2 =10. 773, P= 0. 001, and varied significantly among different grades. CONCLUSIONS： There are expressive deletions of p16 and p15 proteins in primary cervical carcinoma. Both descended expressions of p16, p15 and the overexpression of PCNA may play important roles in the tumour genesis, progression and malignant behavior in cervical carcinomas. The detection of p16, p15 proteins and PCNA can be used to evaluate malignant degree and prognosis of the cervical carcinoma.