肺腺样囊性癌中Myb与预后及p16与HPV感染的关系

Myb,p16 protein expression and HPV infection status in palmonary adenoid cystic carcinoma

目的探讨肺腺样囊性癌（PACC）中Myb蛋白表达及其与预后的关系,p16蛋白表达及其与HPV感染状况的关系。方法收集北京协和医院2000—2014年间PACC共27例,采用免疫组化En Vision法检测其Myb、p16的表达,并对p16阳性细胞数〉40%的病例用原位杂交方法进行HPV检测。结果 27例PACC,男女之比为8∶19,年龄24～74岁,平均年龄51岁;24例为肺原发性,3例为肺转移性。肺原发性病例中,18例随访1～132个月,其中5例复发或转移,1例死亡;6例失访。19例Myb（＋）（79.2%）,26例p16（＋）（100%）,对p16阳性细胞数〉40%的11例加做HPV ISH均为（-）。无复发和转移组Myb阳性率（66.7%,8/12）低于复发或转移组（100%,8/8）,原发性PACC组Myb阳性率（76.2%,16/21）低于转移性PACC组（100%,3/3）,差异不显著（P〉0.05）。结论大多数PACC中Myb为（＋）,但可能与预后无关。虽然p16也呈（＋）,但未检测到HPV感染,推测其可能不是PACC中p16蛋白阳性的原因。

Objective To explore the Myb and p16 protein expression in palmouary adenoid cystic carcinoma, and the relationship of Myb protein and prognosis, also to detect HPV infection. Method Myb and p16 protein expression were studied in 27 lung adenoid cystic carcinomas by immunohistochemistry （EnVision method）, and HPV detection by in situ hybridization （ISH）. Result The mean age was 51 years （ ranged from 24 - 74 years） with a male/female ratio of 8 ： 19 in 27 cases of lung adenoid cystic carcinoma, 24 cases were primary tumor of the lung, 3 cases were metastatic tumor of the lung, 18 patients of primary lung adenoid cystic carcinoma had followed up ranged from l to 132 months, 5 of which had recurrence or metastasis, l patient died, 6 cases were lost to follow-up. Immunohistochemically, P16 protein was positive in all patients （100%, 26/26）, Myb protein in 19 cases（ 79.16%, 19/24） ; None detected HPV by ISH （0%, 0/11 ）. Myb positive expression rate in without recurrence and metastasis group （66.67 % , 8/12） below it in recurrence or metastasis group （100%, 8/8）, the results did not reach statistical significance （P = 0. 117）. Conclusion Myb protein is positive expression in most lung adenoid cystic carcinoma, but there＇s no evidence to prove that Myb positive expression is associated with prognosis. P16 protein in lung adenoid cystic carcinoma is usually positive expression, but there is not HPV infection to be detected, HPV infection may be not the factor of the P16 protein positive expression in lung adenoid cystic carcinoma.