肺鳞状细胞癌中人类乳头瘤病毒16/18感染和P53蛋白表达的关系

目的研究肺鳞状细胞癌中HPV16／18型感染状态和P53蛋白表达的关系。方法原位杂交检测肺鳞状细胞癌中HPV16／18DNA，免疫组化检测P53蛋白，形态学观察癌组织中的挖空细胞。结果44例肺鳞状细胞癌中，23例（52．27％）HPV16／18型呈整合状态，9例（20．45％）呈大部分游离少许整合状态，12例（27．27％）阴性。15例非肿瘤肺组织标本中未检测到HPV16／18型，差异有极显著性意义（P〈0．01）；27例肺鳞状细胞癌（61．36％）P53蛋白阳性，其表达与HPV16／18在癌细胞中的存在状态有关（P〈0．05）；19例（43．18％）可见挖空细胞。HPV的感染、挖空细胞与肿瘤的分化程度有关（均P〈0．05）。结论HPV感染可能是一部分肺鳞状细胞癌的致癌因素之一，这部分癌中P53的表达显著低于HPV阴性和存在游离状态HPV的病例。挖空细胞某种程度上预示HPV的感染，但不是确定HPV感染的良好指标。

Relationship between HPV 16/18 Infection and P53 Protein Expression in Lung Squamous Cell Carcinomas

Objective To investigate the relationship between the status of HPV infection and the expression of P53 in lung squamous cell carcinomas.Methods In 44 patients with lung squamous cell carcinomas,HPV 16/18 DNA was examined by in situ hybridization,the expression of P53 was detected by immunohistochemistry and koilocytes were measured in carcinomas tissues by morphologic examination.Results Of 44 patients with lung squamous cell carcinomas,12(27.27 %) were negative for HPV,23(52.27 %) integrated form HPV and 9(20.45 %) large number of episomal form and a few integrated form HPV.And no simplex episomal form HPV was found.HPV 16/18 DNA could not be detected in 15 non-carcinomas tissues.There was a significantly higher 16/18 DNA positive rates in carcinomas tissues than non-carcinomas tissues(P<0.01).Of 44 patients,27(61.36 %) were positive for P53 protein.There was significant difference between integrated and other form HPV 16/18 in the expression of P53(P<0.05).In 19 of 44(43.18 %) patients,koilocytes were detected.Koilocytes were significantly associated with infection of HPV and differentiation of carcinomas(P<0.05).Conclusion HPV infection may be a particular agent in the patients with lung squamous cell carcinomas.The expression of P53 was significantly lower in HPV positive patients than that in those with negative HPV or episomal form HPV in lung squamous cell carcinomas.The presence of koilocytes in lung squamous cell carcinomas indicated the infection of HPV,but is not a confirm marker of infection.HPV infections were associated with differentiation of carcinomas.Koilocytes that connect with HPV infection were associated with differentiation of carcinomas tissues.