子宫颈上皮内瘤变及鳞状细胞癌组织中p16^INK4a的表达及临床意义

目的探讨子宫颈上皮内瘤变（CIN）及鳞状细胞癌中p16^INK4a蛋白表达及临床意义。方法应用免疫组织化学技术Envision法检测36例子宫颈鳞状细胞癌、68例CIN及40例形态学善良的子宫颈鳞状上皮（包括慢性炎症及鳞状上皮单纯性增生）中p16^INK4a蛋白的表达。结果CIN组中p16^INK4a蛋白表达阳性率为39．7％（27／68），其中CINI为24．0％（6／25），CINH为36．4％（8／22），CINⅢ为61．9％（13／21），CIN组中p16^INK4a蛋白表达阳性率三组间的差异有统计学意义（P=0．03）；宫颈鳞状细胞癌中p16^INK4a蛋白表达阳性率为66．6％（24／36）；CIN组中p16^INK4a蛋白表达阳性率低于宫颈鳞状细胞癌组，差异有统计学意义（P=0．009）。p16^INK4a蛋白阳性表达率依次为宫颈鳞状细胞癌〉CINIII〉CINII〉CINI，差异有统计学意义（P=0．004）。形态学善良的子宫颈鳞状上皮组中未发现有p16^INK4a蛋白表达阳性细胞。p16^INK4a蛋白过度表达现象（＋＋-＋＋＋）在CIN为23．5％（16／68），宫颈鳞状细胞癌为61．1％（22／36），两组间差异有统计学意义（P=0．0001）。CIN组中p16^INK4a蛋白过度表达现象分别为CINRI（47．6％）〉CINII（18．2％）〉CINI（8．0％），三组间的差异有统计学意义（P=0．005）。p16^INK4a蛋白过度表达现象在CINIII和宫颈鳞状细胞癌明显要多于CINII和CINI。结论p16^INK4a可作为筛选子宫颈癌高危个体有价值的生物学标记。

Clinical significance of P16INK4a protein expression in the CIN and squamous cell carcinoma of the cervix

Objective To analyze the p16^INK4a protein expression in CIN and squamous cell carcinoma and its elinieal significance. Methods p16^INK4a protein expression was detected by immunohistochemical Envision method in 36 cases squamous cell carcinoma of cenvix ,68 cases CIN and 40 cases normal cell cervix tissue. Results p16^INK4a protein positive express rate was 39.7% （27/68） in CIN and 66.6% （24/36） in squamous cell carcinoma of the cervix, p16^INK4a protein positive express rate in invasive carcinoma 〉 CIN III 〉 CIN II 〉 CIN I （P = 0. 004 ）. p16^INK4a protein positive express rate was significantly difference in the different stages of CIN （ P = 0.03 ）. We demonstrate overexpression of the p16^INK4a protein is significantly difference between CIN and squamous cell carcinoma of the cervix（ P = 0.0001 ）. Over expression of the p16^ INK4a protein is significantly higher in CIN III and squamous cell carcinoma of the cervix than that in CIN I and CIN II. Normal cerviacl epithelium and cervical ectopia are p16^INK4a negative. Conclusion p16^ INK4a may be taken as an effictive biomarkers for squamous cell carcinoma and its lesions