流式细胞术检测宫颈脱落细胞中p16、p27表达的研究

Research on detection of p16 expression and p27 expression in cervical exfoliated cells by flow cytometry

目的:探究p16、p27蛋白在宫颈脱落细胞中表达情况与不同级别宫颈病变的相关性及二者对宫颈癌筛查、预防及治疗的指导意义。方法:流式细胞术检测20例宫颈液基细胞学(宫颈TCT)及Cervista HPV HR进行宫颈癌筛查(简称"双筛")均为阴性、30例双筛结果 TCT阴性而HPV阳性(单阳性)、50例双筛均阳性的宫颈液基细胞学标本中p16、p27蛋白的表达。结果:p16在正常宫颈上皮中呈现低表达,随宫颈病变级别的升高逐渐升高,差异有统计学意义(P<0.05);p27在正常宫颈上皮中呈现高表达,随宫颈病变级别的升高逐渐降低,差异有统计学意义(P<0.05),且二者变化与A9组病毒感染关系密切。双筛单阳性与双阴性组中p16、p27的表达差异无统计学意义(P>0.05)。结论:p16表达与宫颈病变严重程度变化趋势相同,p27表达与宫颈病变严重程度变化趋势相反,二者表达与高危型HPV感染相关。p16、p27的表达在ASCUS及LSIL组与HSIL及以上组差异有统计学意义(P<0.01),可实现对LSIL以下病变的分流,提高活检的针对性。

Objective： To explore the correlation between p16 expression and p27 expression in cervical exfoliated cells and different grades of cervical lesions and the guiding significance of p16 and p27 in screening,prevention,and treatment of cervical cancer. Methods： Flow cytometry was used to detect the expressions of p16 protein and p27 protein in cervical exfoliated cells specimens of 20 cases with negative cervical TCT result and negative Cervista human papillomavirus（ HPV） HR result,30 cases with negative cervical TCT result and positive Cervista HPV HR result,and 50 cases with positive cervical TCT result and positive Cervista HPV HR result. Results： The expression of p16 in normal cervical epithelium was low,which increased gradually with the increase of grades of cervical lesions,there was statistically significant difference（ P 〈0. 05）; the expression of p27 in normal cervical epithelium was high,which decreased gradually with the increase of grades of cervical lesions,there was statistically significant difference（ P 〈0. 05）; the changes of p16 and p27 were closely related to viral infection of A9 group. There was no statistically significant difference in the expressions of p16 and p27 between the cases with negative cervical TCT result and negative Cervista HPV HR result and the cases with positive cervical TCT result and positive Cervista HPV HR result（ P 〈0. 05）. Conclusion： p16 expression is positively correlated with severity of cervical lesions,while p27 expression is negatively correlated with severity of cervical lesions; the expressions of p16 and p27 are correlated with high risk HPV infection. There were statistically significant differences in the expressions of p16 and p27 between ASCUS ＋ LSIL group and HSIL and above group（ P 〈0. 01）. The split can be realized under LSIL lesions,as the same time,the target of biopsy is improved.