P16蛋白在子宫颈上皮内瘤变中表达意义与高危型HPV感染的相关性分析

Significance of P16 Protein Expression in Cervical Intraepithelial Neoplasia and in High-Risk Human Papillomavirus Infection

目的:研究P16蛋白在宫颈上皮内瘤变(CIN)中表达的意义,探讨其与高危型人类乳头状瘤病毒(HPV)感染的相关性,以期用P16蛋白的表达预测CIN进展。方法:收集大连大学附属医院2009年1月至2011年5月宫颈活检及手术切除标本137例,免疫组织化学方法检测P16蛋白的表达并评分,HC2方法检测高危型HPV-DNA,并对数据进行分析。结果:P16蛋白表达在慢性子宫颈炎伴鳞状上皮化生中均阴性(0/40),CINⅠ阳性90.91%(20/22),CINⅡ阳性为95.00%(19/20),CINⅢ阳性为100.00%(25/25),浸润性鳞癌阳性为100.00%(30/30)。在慢性子宫颈炎伴鳞化中高危型HPV阳性1例,CINⅠ12例,CINⅡ14例,CINⅢ22例,浸润性鳞癌29例。CIN中感染高危型HPV的病例,P16蛋白均呈阳性表达。结论:P16蛋白可作为区分子宫颈癌及癌前病变与良性反应性增生的标记物,其表达的分层现象能够很好的反映出CIN的分级,P16蛋白阳性表达的评分有助于区分出有高危发展倾向的CIN。

Objective： This study aimed to evaluate the immunohistochemical expression of P16 protein in cervical intraepitheli al neoplasia （CIN）, to discuss the relationship of P 16 expression with highrisk human papillomavirus （HPV） infection, and to predict CIN progression through P 16 expression. Methods： A total of 137 histological specimens （surgical and biopsied uterocervical tissues in our hospital from） 2009 to 2011 were studied. P16 expression was detected by SP immunohistochemistry and semiquantitative scoring. A hybridcapture I1 assay for highrisk HPVDNA detection was performed. These data were statistically analyzed. Results： Immuno histochemical staining showed that pl6 expression was negative in all cases of chronic cervicitis accompanied with squamous metapla sia （0/40）. By contrast, P16 protein expression was positive in 20 cases ofCIN Ⅰ （20/22）, 19 cases of C1N Ⅱ （19/20）, 25 cases of CINⅢ （25/25）, and 30 cases of invasive squamous cell cervical carcinoma （30/30）. The expression of highrisk HPVDNA was positive in 1 case of chronic cervicitis accompanied with squamous metaplasia, 12 cases of CIN I, 14 cases of CINⅡ, 22 cases of CIN Ⅲ, and 29 cases of invasive squamous cell cervical carcinoma. Conclusion： P 16 is a potentially useful biomarker in differentiating among the reac tive hyperplasia of benign lesions, invasive squamous cell carcinoma, and precancerous lesions. P 16 expression has different stratifica tions that can highly reflect the grading of CIN. The semiquantitative scoring of P16 expression may be a possible predictor of CIN le sion progression.