HPVL1及P16蛋白在诊断宫颈鳞状上皮病变的应用及价值

Value of Diagnosis Cervical Squamous Epithelial Lesions with HPV L1 and P16 Protein

目的探讨人乳头状瘤病毒(HPV)主要衣壳蛋白L1(HPVL1)及P16蛋白的表达在宫颈鳞状上皮病变中的诊断及应用价值。方法选取本院2015年1月至2015年10月HPV检测高危阳性的215名患者的常规病理切片,其中慢性宫颈炎101例,宫颈上皮内瘤变(CIN)Ⅰ级60例,CINⅡ级27例,CINⅢ级21例,鳞状细胞癌(SCC)6例,运用免疫组织化学染色检测各组活检标本中HPV L1、P16的表达,并对结果进行统计分析。结果HPVL1蛋白在宫颈炎标本表达率为66.33%(67/101),CINⅠ表达率为71.67%(43/60),CINⅡ表达率为25.92%(7/27),CINⅢ表达率为9.52%(2/21),SCC表达率为0%(0/6);P16蛋白在宫颈炎标本表达率为69.31%(70/101),CINⅠ表达率为58.33%(35/60),CINⅡ表达率为85.19%(23/27),CINⅢ表达率为95.24%(20/21),SCC表达率为100%(6/6);HPVL1蛋白表达率在宫颈上皮病变中(CINⅠ、CINⅡ、CINⅢ、SCC)随着宫颈上皮病理分级升高而下降(P<0.05),但炎症中的表达率与CINⅠ中的表达率无明显差异(P>0.05);相反,P16蛋白表达率在宫颈上皮病变中随病理分级升高而升高,二者的表达成负相关(P<0.05)。结论对于宫颈筛查HPV阳性的患者,联合检测HPVL1蛋白和P16蛋白的表达,有一定的诊断价值。

Objective To investigate the expression of major capsid protein L1 and P16 protein in the human papilloma virus （ HPV） , and determine its value in the diagnosis and application of cervical squamous epithelial lesions. Methods 215 cases of high risk with HPV positive expression were collected from Luoyang Central Hospital, whicht including 101 cases of chronic cervicitis, 60 cases of CIN grade Ⅰ, 27 cases of CIN grade Ⅱ, 21 cases of CIN grade Ⅲ and 6 cases of squamous cell carcinoma （ SCC ） . Immunohistochemical staining was used to detect the expression of HPV L1 and P16 protein of all cases. Results The expression rate of HPVL1 protein in cervicitis, CIN Ⅰ, CIN Ⅱ, CIN Ⅲ and SCC were 66. 33%（67/101）, 71. 67%（43/60）, 25. 92%（7/27）, 9. 52%（2/21） and 0%（0/6）, respectively. The expression rate of P16 protein in cervicitis, CINⅠ, CINⅡ, CINⅢand SCC were 69. 31%（70/101）, 58. 33%（35/60）, 85. 19%（23/27）, 95. 24%（20/21） and 100%（6/6） , respectively. The rate of expression of HPVL1 protein in cervical intraepithelial lesions （ CIN Ⅰ and CIN Ⅱ, CIN Ⅲ, SCC ） decreased with the increasing of pathological grade of cervical epithelium （ P 〈0 . 05 ） , but there was no significant difference between cervicitis and CIN I （P〉0. 05）. On the contrary, the expression rate of P16 in cervical intraepithelial lesions increased with the increasing of pathological grade. It was a negative correlation between the expression of the two proteins （P〈0. 05）. Conclusion Combined detection of HPV L1 and P16 protein had a certain diagnostic value in cervical disease screening with HPV positive patients.