p53、p16和Ki-67在阴茎癌及癌前病变中的表达及其意义

The expression of p53, p16 and Ki-67 in penile cancer and their significances

目的研究免疫组织化学指标p53、p16和Ki-67在阴茎癌及癌前病变中的表达及意义。方法回顾性分析2004年1月至2013年12月实施局部广泛切除术的33例阴茎癌患者的病理资料，EnVision／HRP二步法检测p53、p16及Ki-67的表达。结果p53蛋白在正常阴茎组织、低级别上皮内瘤变、高级别上皮内瘤变、高分化鳞状细胞癌及低分化鳞状细胞癌中的表达率分别为0、16．7％、38．5％、30．0％及66．7％。p16蛋白在正常阴茎组织、低级别上皮内瘤变、高级别上皮内瘤变、高分化鳞状细胞癌及低分化鳞状细胞癌中的表达率分别为20．0％、50．0％、53．8％、70．0％及33．3％。Ki-67蛋白在正常阴茎组织、低级别上皮内瘤变、高级别上皮内瘤变、高分化鳞状细胞癌及低分化鳞状细胞癌中的表达率分别为0、16．7％、61．5％、65．0％及75．0％。结论p16和Ki．67联合检测可能早期发现阴茎癌前病变及早期阴茎癌。p53可能与低分化鳞状细胞癌的发生、发展有关，而p16与高分化鳞状细胞癌的发生、发展有关。

Objective To evaluate the expression of immunohistochemistry markers p53, p16 and Ki-67 in penile cancer and penile intraepithelial neoplasia （PIN）. Methods 33 patients who suffered penile cancer and received organ-sparing surgery from Jan 2004 to Dec 2013 were retrospectively analysed. The expression of p53, p16 and Ki-67 were detected by EnVision/HRP two steps immunohistochemistry. Results The positive expression rates of p53 in normal penile epithelium, low-grate penile intraepithelial neoplasia, high-grate penile intraepithelial neoplasia, well-differentiated squamous cell carcinoma and poor-differentiated squamous cell carcinoma were 0, 16.7 %, 38.5 %, 30.0 % and 66.7 % respectively. The expression rates of p16 were 20.0 %, 50.0 %, 53.8 %, 70.0 % and 33.3 % respectively. The expression rates of Ki-67 were 0, 16.7 %, 61.5 %, 65.0 % and 75.0 % respectively. Conclusions The combined detection of p16 and Ki-67 can contribute to discover PIN and penile carcinoma much more earlier, p53 may be related to the occurrence and development of low differentiated squamous cell carcinoma, and p16 may be related to the occurrence and development of well-differentiated squamous cell carcinoma.