宫颈上皮内瘤变p16、Rb、Ki-67及高危型HPV的表达

p16,Rb,Ki-67 and High-risk HPV Expressions in Cervical Intraepithelial Neoplasia

目的研究p16、Rb、Ki-67在宫颈上皮内瘤变(CIN)中的表达,探讨其与HPV感染的关系。方法对121例CIN病变上皮和36例正常上皮行免疫组化染色检测p16、Rb及Ki-67表达情况,其中47例CIN病例用原位杂交法检测高危型HPV感染情况。结果与对照组相比p16、Ki-67在各级别CIN中均有较高表达(P<0.01),且CIN2和CIN3中的表达较CIN1高(P<0.05);同时二者阳性表达均见分层现象。Rb蛋白的阳性率及表达强度从CIN1到CIN3逐渐下调(分别为54.2%、24.4%、21.9%),在对照组与各级别CIN之间差异均有显著性(P<0.01),但CIN2与CIN3之间无差别。CIN1、CIN2及CIN3患者高危型HPV阳性率分别为(71.9%)、(85.3%)和(90.6%),随CIN级别的增加而升高,与对照组相比差异有统计学意义(P<0.01),但不同级别CIN之间差别无统计学意义。结论高危型HPV感染及p16、Ki-67及Rb与宫颈癌前病变发生机制及病变进展相关,联合检测p16蛋白和Ki-67、Rb抗原表达可作为CIN分级诊断的辅助方法。

Objective To investigate the association between p16,Rb and Ki-67 expression and high-risk human papilloma virus（HPV） infection in cervical intraepithelial neoplasia（CIN）.Methods p16,Rb,and Ki-67 protein expression was detected in 121 cases of CIN and 36 cases of normal cervical epitheliums by immunohistochemistry;and high-risk HPV infection was detected by in site hybridization.Results The expression of p16,high-risk HPV and Ki-67 was significantly higher in CIN than that of control groups（P〈0.01）;Rb expression was significantly lower in CIN than that of control groups（P〈0.01）;but no significant difference occurred between CIN 2 and CIN 3.Conclusion High-risk HPV infection and p16,Rb,Ki-67 overexpression all play important roles in the carcinogenesis of cervical precancerous lesion,and both p16,Rb and Ki-67 expression are useful markers in diagnosis and staging of CIN.