p63、CD44v6及HPV16/18在子宫颈癌及癌前病变中的表达及意义

  目的　探讨p63、CD44v6及HPV16/18在不同子宫颈组织病变中的表达及临床病理意义。方法　制作包含有60例子宫颈癌，55例子宫颈上皮内瘤变（CIN），30例健康人子宫颈上皮的组织芯片，采用免疫组织化学及原位杂交方法检测p63、CD44v6及HPV16／18 在145 例子宫颈病变组织中的表达情况。结果　p63、CD44v6及HPV16／18在子宫颈癌中的表达与CIN和对照组比较差别均有统计学意义（P＜0.05）；HPV16／18在CIN组随着级别增高阳性表达率升高（27.3 %，43.8 %，70.6 %）；p63主要在鳞状细胞癌中表达，在腺癌中不表达；p63阳性率与鳞状细胞癌的分级、临床分期有关；CD44v6的阳性率与肿瘤的病理分级和临床分期有关，并且淋巴结转移病例的阳性率明显高于无转移的病例（P＜0.05）。HPV16／18与p63表达程度相关（P＜0.05），Cp值为0.49。结论　HPV16／18参与子宫颈鳞状细胞癌的发生和发展，p63可能作为癌基因参与了HPV16／18的致瘤过程，并可作为向鳞状上皮分化的恶性肿瘤的标记之一；CD44v6可以作为判断子宫颈癌远处转移指标之一。

Expression and clinical significance of p63, CD_(44v6) and human papilloma virus 16/18 in carcinoma of cervix and precancerous lesion

Objective To investigate the expression and clinical significance of p63, CD_(44v6) and human papilloma virus (HPV) 16/18 in carcinoma of cervix and precancerous lesion and to study their role in the pathogenesis of the infiltrative carcinoma of the cervix(ICC). Methods 145 patients were selected, among whom were 60 cases of ICC, 55 cases of cervical intraepithelial neoplasia (CIN) and 30 cases of normal cervical epidermis (NCE). Immunohistochemistry streptavidin peroxidase (SP) was used to detect the expressions of p63 and CD_(44v6) protein and hybridization in situ was used to measure HPV 16/18 gene on tissue microarray. Results HPV 16/18, p63 and CD_(44v6) in ICC were significantly higher than those in CIN and NCE groups (P < 0.05). The expressions of HPV 16/18 gene in CIN I 、CIN II and CIN III were 27.3 % , 43.8 %, 70.6 % respectively. p63 protein was mainly expressed in squamous cell carcinoma, but not in adenocarcinoma. p63-positive rate was related to the grade of squamous cell carcinoma and clinical stage. CD_(44v6) positive rate was related to the pathological grade and clinical stage. Moreover, the positive rate of lymph node metastasis was significantly higher than the cases without metastasis (P <0.05). The expression of HPV16/18 was positively correlated with that of p63 in ISCC (P <0.05, Cp =0.49). Conclusion HPV16/18 possibly participate in the pathogenesis and progress of cervical squamous carcinoma. p63, as the cancer gene, may participate in the occurrence and development of cervical cancer caused by HPV 16/18. p63 could be a differentiation indicator of cervical squamous carcinoma, and it could be one of the markers which would be differentiated into squamous cell in malignant tumour. CD_(44v6) could be used as one of the indicators of distant metastasis of cervical cancer.