CIN和宫颈浸润癌组织中p16^(INK4a)蛋白表达检测的意义

The Significance of p16^(INK4a) protein Expression in the CINs and invasive carcinoma of the cervix

目的研究p16INK4a蛋白表达在宫颈浸润癌前病变(CIN)和宫颈浸润癌组织中的意义。方法应用免疫组化技术对68例CIN和36例宫颈浸润癌病变组织中p16INK4a蛋白表达进行检测。结果CIN组中p16INK4a蛋白表达阳性率为39.7%(27/68),其中CINⅠ为24.0%(6/25),CINⅡ为36.4%(8/22),CINⅢ为61.9%(13/21)。CIN组中p16INK4a蛋白表达阳性率3组间的差别有统计学意义(P=0.03)。宫颈浸润癌组织中p16INK4a蛋白表达阳性率为66.6%(24/36)。CIN组中p16INK4a蛋白表达阳性率低于宫颈浸润癌组,差别有统计学意义(P=0.009)。p16INK4a蛋白阳性表达率依次为宫颈浸润癌>CINⅢ>CINⅡ>CINⅠ,差异有统计学意义(P=0.004)。正常宫颈上皮和宫颈糜烂组中未发现有p16INK4a蛋白表达阳性细胞。p16INK4a蛋白过度表达现象(++^+++)在CIN为23.5%(16/68),宫颈浸润癌为61.1%(22/36),两组间差别有统计学意义(P=0.0001)。CIN组中p16INK4a蛋白过度表达现象分别为CINⅢ(47.6%)>CINⅡ(18.2%)>CINⅠ(8.0%),3组间的差别有统计学意义(P=0.005)。p16INK4a蛋白过度表达现象在CINⅢ和宫颈浸润癌明显要多于CINⅡ和CINⅠ。结论p16INK4a蛋白表达的检测可能作为在CIN人群中筛选高危个体的标志物。尤其是有过度表达现象出现时的意义更大。

Objective To discuss the expression of p16^INK4a protein and its clinical pathological characteristics in the CINs and invasive carcinoma of the cervix. Methods The expression of p16^INK4a protein in 68 cases of CINs and 36 cases of invasive carcinoma of the cervix were detected by immunohistochemical staining. Results p16^INK4a protein positive express rate was 39.7 % （27/68） in CINs and 66.6% （24/36）in invasive carcinoma of the cervix. p16^INK4a protein positive express rate in invasive carcinoma 〉 CIN Ⅲ 〉 CIN Ⅱ 〉 CIN Ⅰ （ p = 0.004 ）, p16^INK4a protein positive express rate was significantly difference in the different stages of CINs （ P = 0.03 ）. We demonstrate overexpression of the p16^INK4a protein is significantly difference between CINs and invasive carcinoma of the cervix（ P = 0.0001 ）. Overexpression of the p16^INK4a protein is significantly higher in CIN Ⅲ and invasive carcinoma of the cervix than that in CIN Ⅰ and CIN Ⅱ. Normal cerviacl epithelium and cervical ectopia are p16^INK4a-negative. Conclusion It is suggested that p16^INK4a protein expression,especially overexpression of p16^INK4a protein may be taken as an effective biomarkers for early detection of high risk groups ha CIN lesion.