子宫颈上皮内瘤变及鳞状细胞癌组织中p16^(INK4a)的表达及临床意义

Clinical significance of P16^(INK4a) protein expression in the CIN and squamous cell carcinoma of the cervix

目的探讨子宫颈上皮内瘤变(CIN)及鳞状细胞癌中p16INK4a蛋白表达及临床意义。方法应用免疫组织化学技术Envision法检测36例子宫颈鳞状细胞癌、68例CIN及40例形态学善良的子宫颈鳞状上皮(包括慢性炎症及鳞状上皮单纯性增生)中p16INK4a蛋白的表达。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蛋白表达阳性率三组间的差异有统计学意义(P=0.03);宫颈鳞状细胞癌中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鳞状细胞癌组,差异有统计学意义(P=0.009)。p16INK4a蛋白阳性表达率依次为宫颈鳞状细胞癌>CINⅢ>CINⅡ>CINⅠ,差异有统计学意义(P=0.004)。形态学善良的子宫颈鳞状上皮组中未发现有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),宫颈鳞状细胞癌为61.1%(22/36),两组间差异有统计学意义(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%),三组间的差异有统计学意义(P=0.005)。p16INK4a蛋白过度表达现象在CINⅢ和宫颈鳞状细胞癌明显要多于CINⅡ和CINⅠ。结论p16INK4a可作为筛选子宫颈癌高危个体有价值的生物学标记。

Objective To analyze the p16^INK4a protein expression in CIN and squamous cell carcinoma and its elinieal significance. Methods p16^INK4a protein expression was detected by immunohistochemical Envision method in 36 cases squamous cell carcinoma of cenvix ,68 cases CIN and 40 cases normal cell cervix tissue. Results p16^INK4a protein positive express rate was 39.7% （27/68） in CIN and 66.6% （24/36） in squamous cell 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 CIN （ P = 0.03 ）. We demonstrate overexpression of the p16^INK4a protein is significantly difference between CIN and squamous cell carcinoma of the cervix（ P = 0.0001 ）. Over expression of the p16^ INK4a protein is significantly higher in CIN III and squamous cell carcinoma of the cervix than that in CIN I and CIN II. Normal cerviacl epithelium and cervical ectopia are p16^INK4a negative. Conclusion p16^ INK4a may be taken as an effictive biomarkers for squamous cell carcinoma and its lesions