p16INK4a蛋白在人恶性肿瘤组织中的表达及临床意义#br# #br#

目的 探讨p16INK4a蛋白在多种人恶性肿瘤组织中的表达及临床意义。方法 收集2014年至2015年手术切除的肿瘤标本642例。免疫组化染色检测并分析p16INK4在肿瘤组织中的表达。 结果642例肿瘤样本中良性肿瘤120例、恶性肿瘤522例。免疫组化检测p16INK4a在恶性肿瘤组织中表达阴性（-）、弱阳性（+）、中等阳性（++）和强阳性（+++）表达率分别为17.43％（91／522）、11.11％（58／522）、19.16％（100／522）和5230％（273／522），而在良性病变中表达率分别为34.17％（41／120）、23.33％（28／120）、26.67％（32／120）和1583％（19／120），差异具有统计学意义（P＜0.05）。在不同组织来源的肿瘤中p16INK4a蛋白阳性表达率也并不相同（P＜0.05）。分别以阳性免疫组化染色“++”和“+++”作为p16INK4A阳性表达界值，则p16INK4A 蛋白作为恶性肿瘤分子标志的灵敏度、特异度和阳性预测值分别为71.46％、57.50％、87.97％和52.30％、84.17％和93.49％。结论 p16INK4A 代偿性高表达是人恶性肿瘤特异性的免疫表型，可作为恶性肿瘤诊断、鉴别诊断和分子分型的分子标志。

Expression of p16INK4a in human malignant tumors and its clinical significance

ObjectiveTo investigate the expression of p16INK4a protein in human cancers and analyze its clinical significance. MethodsA total of 642 cases surgical specimens of primary human tumors from 2014 to 2015 were underwent operations in the study. Immunohistochemical staining was used to detect and analyze the expression of p16INK4 in tumor tissues. ResultsOf the 642 tumor samples， 120 were benign and 522 were malignant. The expression rates of p16INK4a negative（-）， weak positive（+）， moderately positive（++） and strong positive（+++） were 1743％ （91／522）， 11.11％ （58／522）， 19.16％ （100／522） and 52.30％ （273／522） in malignant tumor tissues， respectively； while in benign lesions， the expression rates were 3417％ （41／120）， 2333％ （28／120）， 26.67％ （32／120） and 1583％ （19／120）， respectively. The difference was statistically significant （P＜0.05）. The positive expression rate of p16INK4a protein in different tissues derived tumors was not the same （P＜0.05）.Using p16INK4a protein as a biological molecules marker of malignant tumor， the sensitivity and specificity and positive predictive value of it were different as choosing different positive cell value. While using moderately positive as positive value， the sensitivity， specificity and positive predictive value were 71.46％， 57.50％ and 87.97％. While using strong positive as positive value， the sensitivity， specificity and positive predictive value were 52.30％，84.17％ and 93.49％. ConclusionThe compensatory high expression of p16INK4A is a tumor specific immune phenotype， which is related to the abnormal cell cycle patterns of tumor， and can be used as a molecular marker for the diagnosis， differential diagnosis and molecular typing of malignant tumors.