p53、p16在宫颈上皮内瘤变及宫颈癌中的表达及意义探讨

Expression and Signification of p53 and p16 in Cervical Intraepithelial Neoplasia and Cervical Carcinoma.

目的:探讨p53、p16在宫颈上皮内瘤变及宫颈癌中的表达及临床意义。方法:应用免疫组化SP法检测79例宫颈上皮内瘤变(CIN)、79例宫颈鳞癌和16例正常宫颈组织中p53、p16的表达。结果:在正常宫颈组织、CIN和宫颈鳞癌中p53的阳性率分别为0.00%、47.77%及60.76%,其表达有统计学意义(P<0.01);p16的阳性率分别为0.00%、37.97%及67.09%,其表达有统计学意义(P<0.01)。在CINⅠ、Ⅱ、Ⅲ级组中p53的阳性率分别为24.14%、42.31%及62.50%,有统计学意义(P<0.05);p16的阳性率分别为13.79%、38.46%及66.67%,(P<0.01)。在CIN伴湿疣组p53及p16的阳性表达均高于无湿疣组,但差异无统计学意义(P>0.05)。随宫颈鳞癌病理分级,p16表达上调(P<0.05),而p53表达下调。结论:p53随CIN分级增加而上调,在鳞癌中呈过表达,p53基因突变与宫颈鳞癌的发生、发展有关,尤其是在宫颈鳞癌发生的早期;随宫颈CIN等级增加及宫颈鳞癌分级增加p16表达显著增加,p16标记可作为宫颈CIN分级与鳞癌诊断的重要辅助指标。

Objective： To investigate the expression and signification of p53 and p16 in cervical intraepithelial neoplasia and cervical carcinoma. Methods： Expression of p53 and p16 were detected by immunohistochemistry method in 79 cases of cervical intraepithelial neoplasia （CIN） ,79 esae of cervical squamous cell carcinoma and 16 normal cervical specimens. Results： In normal cervical specimens ,.CIN and cervical squamous cen carcinoma the positive rates of p53 were 0. 00%, 47. 77% and 60. 76%, respectively with significant difference （ P 〈 0. 01 ） ; In CIN I , Ⅱ, Ⅲ the positive rates of p16 were 0. 00%, 37. 97% and 67. 09%, respectively also with significant difference （P 〈0. 01 ）. The positive rates of p53 were 24. 14%, 42. 31% and 62.50% ,respectively with significant difference （P 〈0. 05 ） ; the positive rates of p16 were 13. 79%, 38. 46%, and 66. 67% ,respectively with significant difference （P 〈 0. 01 ）. The positive rates of p53 and p16 in the those in CIN with condyloma were higher than CIN without condyloma, but without sta- tistic difference （P 〉 0. 05）. With cervical squamous cell careinoma＇ s tumor grades increased the expression of p16 （P 〈 0. 05 ）, while the expression of p53 decreased. Conclusion： The expression of p53 increase with CIN grades increase, and shows overexpres- sion in cervical squamous cell carcinoma, the gene mutant of p53 is associated with the pathogenesis and developoment of cervical squamons cell carcinoma, especially in the early stage of pathogenesis. With cervical squamous cell careinima＇s tumor grades and CIN grades increased,the expression of p16 increases significantly p16 may be an importance in CIN grades and the diagnosis of cervical squamous cell carcinoma.