hr-HPV与4种不同免疫标记物对妇科肿瘤的诊断价值

Diagnostic value of hr-HPV and 4 different immune markers in gynecologic tumors

目的探讨联合检测高危型人乳头瘤病毒(hr-HPV)与4种不同免疫标记物表达组型在宫颈腺癌和子宫内膜腺癌鉴别诊断中的价值分析。方法选取咸阳市中心医院于2014年8月至2016年11月期间收治的35例原发性宫颈腺癌患者及32例子宫内膜腺癌患者,采用原位杂交(ISH)方法来进行hr-HPV(16/18)DNA的检验,以及采用EliVisionTMplus免疫组化染色方法对67例患者肿瘤组织中4种不同免疫标记物雌激素受体(ER)、孕激素受体(PR)、p16、波形蛋白(Vimentin)的表达进行检测。结果宫颈腺癌的hr-HPV(16/18)DNA检出率明显高于子宫内膜腺癌,差异具有统计学意义(χ~2=25.81,P<0.05)。26例hrHPV(16/18)DNA检测呈阳性的病例中ER(L)PR(L)p16(H)Vim(L)表达组型阳性表达率明显高于ER(L)PR(L)p16(L)Vim(L)表达组型,差异有统计学意义(χ~2=21.60,P<0.05)。28例hr-HPV(16/18)DNA检测呈阴性的病例中ER(H)PR(H)p16(L)Vim(H)表达组型阳性表达率明显高于ER(H)PR(L)p16(H)Vim(H)、ER(L)PR(L)p16(L)Vim(H)和ER(L)PR(L)p16(L)Vim(L)3组表达组型,差异具有统计学意义(χ~2值分别为32.54、26.09、29.17,均P<0.05)。结论联合检测hr-HPV与4种不同免疫标记物表达组型在宫颈腺癌和子宫内膜腺癌鉴别诊断中具有重要的临床使用价值。

Objective To investigate the value of combined detection of high-risk human papilloma virus（hr-HPV）and 4 kinds of different immune markers expression pattern in differential diagnosis of cervical adenocarcinoma and endometrial adenocarcinoma.Methods Thirty-five cases of primary cervical adenocarcinoma and 32 cases of endometrial adenocarcinoma admitted in Xianyang Central Hospital from August 2014 to November 2016 were selected.Hybridization in situ（ISH）was employed to test hr-HPV（16/18）DNA.Expression of four immune markers,including estrogen receptor（ER）,progesterone receptor（PR）,cervical squamous cancer（p16）and fibrosarcoma（Vimentin）in tumor tissue in 67 patients were examined with method of EliVisionTM plus immunohistochemical staining.Results Detection rate of hr-HPV（16/18）DNA in cervical adenocarcinoma was significantly higher than that in endometrial adenocarcinoma,and difference was statistically significant（χ~2=25.81,P〈0.05）.In 26 cases of hr-HPV（16/18）DNA positive expression,positive rate in cases of ER（L）PR（L）p16（H）Vim（L）expression pattern was significantly higher than that in ER（L）PR（L）p16（L）Vim（L）expression pattern,and difference was statistically significant（χ~2=21.60,P〈0.05）.In 28 cases of hr-HPV（16/18）DNA negative,positive expression rate in ER（H）PR（H）p16（L）Vim（H）expression pattern was significantly higher than that in ER（H）PR（L）p16（H）Vim（H）,ER（L）PR（L）p16（L）Vim（H）and ER（L）PR（L）p16（L）Vim（L）expression pattern,and differences were statistically significant（χ~2 value was 32.54,26.09,29.17 respectively,all P〈0.05）.Conclusion Combined detection of hr-HPV and 4 kinds of different immune marker expression pattern has important clinical value in differential diagnosis of cervical adenocarcinoma and endometrial adenocarcinoma.