CK10、p16蛋白在早期宫颈癌组织中的表达及其与预后的关系

Expression of CK10 and p16 proteins in early cervical cancer tissue and their relationship with prognosis

目的 分析CK10、p16蛋白在早期宫颈癌组织中的表达及其与预后关系,以期能为后期临床治疗提供指导。方法 选取首都医科大学附属北京佑安医院2015年1月至2017年1月采集的宫颈石蜡标本共200例,其中正常宫颈组织50例(A组),低级宫颈鳞状上皮内病变50例(B组),高级宫颈鳞状上皮50例(C组),早期宫颈癌50例(D组)。采用免疫组化方法检测并比较各组CK10、p16蛋白的阳性表达,分析CK10、p16蛋白表达对早期宫颈癌患者临床特征及预后的影响。结果 CK10蛋白在A、B、C、D组的阳性率分别为80.00%、66.00%、34.00%和22.00%,在早期宫颈癌中的阳性表达率最低,其次是宫颈病变,且随着病情的加重而降低。p16蛋白在A、B、C、D组的阳性率分别为10.00%、36.00%、64.00%和90.00%,在早期宫颈癌中阳性率最高,其次为宫颈病变,且随着病情的加重而增高;肿瘤中高分化、无淋巴结转移、浅层浸润间质的早期宫颈癌患者CK10蛋白阳性率较高差异有统计学意义(Z=5.279、4.781、5.383,P<0.05);肿瘤低分化、有淋巴结转移的早期宫颈癌患者p16蛋白阳性率较高(Z=4.236、5.078,P<0.05);随访5年内,CK10蛋白阴性表达患者2例因肿瘤复发死亡,阳性表达无一例死亡;p16蛋白阴性表达患者无一例死亡,阳性表达2例因肿瘤复发或转移死亡。CK10蛋白阳性表达及p16蛋白阴性表达患者的预后较佳。结论 CK10、p16的表达水平与宫颈病变程度呈负相关或正相关,肿瘤中高分化、无淋巴结转移、浅层浸润间质的早期宫颈癌患者CK10蛋白阳性率较高,预后较佳;肿瘤低分化、有淋巴结转移的早期宫颈癌患者p16蛋白阳性率较高,预后较差。

Objective To analyze the expression of CK10 and p16 proteins in early cervical cancer tissues and their relationship with prognosis,in order to provide guidance for later clinical treatment.Methods A total of 200 cervical paraffin specimens were collected from Beijing Youan Hospital affiliated with Capital Medical University from January 2015 to January 2017.Among them,50 were normal cervical tissue(Group A),50 were low-grade cervical squamous intraepithelial lesions(Group B),50 were high-grade cervical squamous epithelium(Group C),and 50 were early cervical cancer(Group D).Immunohistochemical methods were used to detect and compare the positive expression of CK10 and p16 proteins in each group,and analyze the influence of CK10 and p16 protein expression on the clinical characteristics and prognosis of patients with early cervical cancer.Results The positive rates of CK10 protein in groups A,B,C and D were 80.00%,66.00%,34.00%and 22.00%,respectively.The positive expression rate was the lowest in early cervical cancer,followed by cervical lesions,which decreased as the condition worsened.The positive rates of p16 protein in groups A,B,C and D were 10.00%,36.00%,64.00%and 90.00%,respectively.The positive rate was the highest in early cervical cancer,followed by cervical lesions,which increased with the severity of the disease.The positive rate of CK10 protein in early cervical cancer patients with well-differentiated tumors,no lymph node metastasis,and superficial infiltrating stroma is higher(Z=5.279,4.781,5.383,P<0.05).The positive rate of p16 protein is higher in early cervical cancer patients with poorly differentiated tumors and lymph node metastasis(Z=4.236,5.078,P<0.05).Within 5 years of follow-up,2 patients with negative expression of CK10 protein died due to tumor recurrence,while no patient with positive expression died.No patients with negative expression of p16 protein died,while 2 patients with positive expression died due to tumor recurrence or metastasis.Patients with positive CK10 protein expression and negative p16 protein expression have a better prognosis.Conclusion The expression levels of CK10 and p16 are negatively correlated or positively correlated with the degree of cervical lesions.Early cervical cancer patients with highly differentiated tumors,no lymph node metastasis,and superficial infiltrating stroma have a higher positive rate of CK10 protein and a better prognosis.Early cervical cancer patients with poorly differentiated tumors and lymph node metastasis have a higher positive rate of p16 protein and a poorer prognosis.