免疫组化和核酸原位杂交在尖锐湿疣病理诊断中的意义

The Significance of Detecting Human Papillomavirus by Immunohistochemistry and in situ Hybridization in the Pathologic Diagnosis of Condyloma Acuminatum

目的 探讨免疫组化和核酸原位杂交检测人乳头瘤病毒 (HPV)在尖锐湿疣 (CA)病理诊断中的意义。方法 44例病理形态学诊断为尖锐湿疣的石蜡包埋组织标本 ,用 HPV多克隆抗体和 HPV- 11单克隆抗体行免疫组化染色 ;用分别针对 HPV6和 HPV11- DNA的寡核苷酸探针行原位杂交。结果 1免疫组化染色 :37/4 4例(84.1%) HPV多克隆抗体染色阳性 ;6 /4 4例 (13.7%) HPV- 11单克隆抗体染色阳性 ;2原位杂交 :有 38/4 4例(86 .4%)表达 HPV- DNA,其中既表达 HPV6 - DNA又表达 HPV11- DNA者 2 6例 (5 9.1%) ;3联合应用免疫组化和原位杂交技术检测 ,有 43/4 4例 (97.7%)呈阳性反应。结论 免疫组化和原位杂交技术检测 HPV是病理诊断尖锐湿疣的重要辅助手段 ,二者的联合使用明显提高了 HPV的检出率。在临床应用中结合形态学改变 ,可提高尖锐湿疣诊断的准确性。

Objective To evaluate the significance of detecting human papillomavirus(HPV) by immunohistochemistry(IHC) and in situ hybridization(ISH) in the diagnosis of condyloma acuminatum(CA). Methods Forty-four cases of paraffin-embedded tissue specimens which were diagnosed as CA previously were examined in this study. HPV-Ag was estimated using HPV polyclonal antibody and HPV11 monoclonal antibody by IHC. HPV type 6-DNA and 11-DNA were detected using corresponding oligonucleotide probe by ISH. Results By IHC, 37/44 (84.1%) cases were positive for HPV polyclonal antibody, and 6/44 (13.7%) cases were positive for HPV monoclonal antibody. By ISH, 38/44 (86.4%) cases expressed HPV-DNA, and among them, 26/44 (59 1%) cases expressed both HPV6-DNA and HPV11-DNA. By combined use of IHC and ISH, the positive cases were increased to 43/44(97.7%). Conclusion The results demonstrate that IHC and ISH are important assistant means for the pathological diagnosis of CA, and the application of combined IHC and ISH has apparently increased the positive rate for detection of HPV, thus suggesting that the clinical use of IHC and ISH in association with the morphologic changes can enhance the diagnostic rate of CA.