p16蛋白和PCNA在角化型外阴鳞癌中的表达及其意义

Expression and significance of p16 protein and PCNA in keratinizing vulva squamous cell carcinomas

目的:探讨p16基因和PCNA在角化型外阴鳞癌(VSCCs)发生、发展中的作用。方法:应用免疫组织化学方法检测p16蛋白及细胞增殖核抗原(PCNA)在21例角化型VSCCs、7例外阴上皮内瘤变(VIN)和53例外阴上皮内非瘤样病变(NNED)中的表达。结果:在NNED、VIN和VSCCs中p16蛋白表达率呈下降趋势(P<0.05),而PCNA标识指数(PI)呈上升趋势(P<0.01)。NNED组中p16蛋白表达率显著高于VSCCs和VIN组(P<0.05,P<0.05)。PI在NNED、VIN及VSCCs组中经两两比较,差异均有显著性(P<0.05)。PI与VSCCs组织分级相关(P<0.05)。p16蛋白高表达与PI呈负相关(P<0.05)。结论:p16和PCNA异常表达可能在角化型VSCCs发生、发展中起作用,PCNA可作为判断VSCCs恶性程度的指标。

To investigate the roles of p16 and proliferation cell nuclear antigen （PCNA） in carcinogenesis of keratinizing vulva squamons cell carcinomas （VSCCs） . Methods： 21 cases of keratinizing VSCCs, 7 cases of vulva intraepithelial neoplasia （VIN） and 53 cases of non - neoplastic epithelial disorders （NNED） were investigated with immunohistochemical staining to determine expression of p16 and PCNA proteins. Results： A significant decrease of high p16 protein expression rate from NNED, through VIN, to VSCCs （P 〈 0. 05）, while the PCNA labeling index （PI） showed inversely （P 〈0. 01 ）. High p16 protein expression rate was significantly higher in NNED than those in VIN and VSCCs （P 〈 0. 05, P 〈 0. 05）. There was significant difference in PI between NNED and VIN （P 〈 0. 05） or VIN and VSCCs （P 〈 0. 05）. Significant correlations were found between PI and the histopathology grade of the cancer cells （P 〈 0. 05）. PI in tumors with high p16 protein expression was lower than in those with low p16 protein expression （P 〈0. 05） . Conclusion： The inactive p16 gene may be involved in the carcinogenesis of keratinizing VSCCs. PCNA may serve as parameters for determining tumor biological behavior.