P16INK4a蛋白在宫颈脱落细胞的表达及意义

目的探讨p16INK4A蛋白在宫颈脱落细胞即液基细胞学薄片(liquid-based cytology test,LCT)的表达及其用于宫颈鳞状细胞癌(squamous cell carcinomas,SCC)筛查的意义。方法225例宫颈病变患者,其中宫颈鳞状细胞癌(squamous cell carcinomas,SCC)56例,高度鳞状上皮内病变(high grade squamous intraepithelial lesions,HSIL)41例,低度鳞状上皮内病变(low grade squamous intraepithelial lesions,LSIL)76例,不典型鳞状细胞(atypical squa-mous cell lesions,ASC)32例,正常范围(within normal limits,WNL)20例。采用免疫组化方法,检测p16INK4A的表达。比较P16INK4a联合LCT及单纯LCT的病理诊断符和率。结果单纯LCT的病理诊断符合率为LSIL52.08%,HSIL77.14%,SCC 98.21%;P16INK4a联合LCT的病理诊断符合率为LSIL 68.75%(33/48),HSIL 91.43%(32/35),SCC100%(56/56);差异有显著性(P<0.05)。32例ASC的P16INK4a联合LCT阳性病理诊断符合率为71.43%,与单纯LCT相比,差异有显著性(P<0.05)。结论P16INK4a联合LCT可用于宫颈癌的筛查,尤其对于ASC的确诊,较单纯LCT有更高的病理诊断符合率,可以提高宫颈癌的诊断准确性。

The express and significance of protein P16INK4a in cervix cell

Objective:To study the expression of protein P16INK4a in cervical cell and investigate the value of liquid-based cytology test(LCT) in combination with P16INK4a in the diagnosis of squamous cell carcinomas(SCC).Methods: 225 patients were investigated in the present study,including 56 squamous cell carcinomas(SCC),41 high grade squamous intraepithelial lesions (HSIL),76 low grade squamous intraepithelial lesions(LSIL),32 atypical squamous cell lesions(ASC) and 20 cases within normal limits(WNL).LCT was used in all the patients.Immunohistochemistry was performed to examine the expressions of P16INK4a.The pathological results were used as the gold standard to evaluate the results of LCT method and P16INK4a in combination with LCT.Results: Compared with the pathological results,the accuracies of LCT method were 52.08%,77.14% and 98.21% in LSIL,HSIL,SCC respectively.The accuracies of P16INK4a in combination with LCT were 68.75%,91.43%,and 100% in LSIL,HSIL and SCC respectively.The difference was significant(P<0.05).In 32 cases of ASC,the accuracy of P16INK4a in combination with LCT was 71.43%,compared with LCT method and the difference was significant(P<0.05).Conclusion: P16INK4a in combination with LCT may be a useful method in screening of SCC,especially in the diagnosis of ASC.