P16^(INK4A)在宫颈液基细胞学涂片中的表达及意义

Expression and significance of P16^(INK4A) in cervical liquid-based cytological smear

目的观察P16INK4A蛋白在宫颈液基细胞学涂片中的表达,探讨其在宫颈癌及宫颈上皮内肿瘤早期诊断中的意义。方法用免疫细胞化学法检测50例非典型鳞状上皮细胞(ASC-US),50例低度鳞状上皮内病变(LSIL),50例高度鳞状上皮内病变(HSIL),40例鳞状细胞癌(SCC)以及20例未见恶性细胞和上皮内病变细胞(NILM)的Thin Prep(TCT)涂片上P16INK4A蛋白、人乳头瘤病毒(HPV)16/18-E6蛋白及HPV16,18 DNA的表达情况。结果 1NILM、ASC-US、LSIL、HSIL及宫颈癌液基薄层细胞(TCT)涂片中P16INK4A蛋白阳性率分别为无表达、48%、64%、84%、95%。2NILM、ASC-US、LSIL、HSIL及宫颈癌TCT涂片中HPV16/18-E6蛋白表达阳性率现在增高。3P16INK4A与HPV16,18 DNA及蛋白表达呈正相关。结论 P16INK4A在HSIL以及SCC中表达显著增高,并与HPV16,18感染密切相关,可以作为宫颈癌及宫颈上皮内瘤变早期诊断的辅助诊断指标。

Objective To determine the expression of P16^INK4A protein in cervical liquid-based cytological smear, and investigate its significance in the early diagnosis of cervical cancer and cervical intraepithelial neoplasia （CIN）. Methods The expressions of P16^INK4A protein, HPV16/18-E6 protein, and HPV16, 18DNA in the ThinPrep （TCT） smears from 50 cases of atypical squamous cell-undetermined significance （ASC-US）, 50 of low-grade squamous intraepithelial lesions （LSIL）, 50 of high-grade squamous intraepithelial lesions （HSIL）, 40 of squamous cell carcino-mas （SCC）, and 20 cases negative for intraepithelial lesion or malignancy （NILM） were determined by immunocyto-chemical method. Results ①The positive rate of P16^INK4A expression in the TCT smears of NILM, ASC-US, LSIL, HSIL and cervical cancer was 0, 48%, 64%, 84%, and 95%, respectively. ②The positive rate of HPV16/18-E6 ex-pression in the TCT smears of NILM, ASC-US, LSIL, HSIL and cervical cancer was significantly increased. ③A posi-tive correlation was found between the expression of P16 INK4A and HPV16, 18 DNA. Conclusion The expression of P16^INK4A is significantly increased in HSIL and SCC, which may be closely associated with HPV 16, 18 infections. This finding can be used as an auxiliary indicator in early diagnosis of cervical cancer and CIN.