宫颈腺癌和子宫内膜腺癌中hr-HPV(16/18)DNA和p16,Vimentin,ER,PR表达组型的检测及鉴别诊断价值

目的:探讨hr-HPV(16/18)DNA及4种免疫标记物(p16,Vimentin,ER,PR)表达组型的检测在宫颈腺癌(ECA)和子宫内膜腺癌(EMA)鉴别诊断中的价值。方法:分别采用原位杂交和免疫组化(EliVisionTMplus)法对ECA和EMA肿瘤组织中的hr-HPV(16/18)DNA和4种免疫标记物(p16,Vimentin,ER,PR)的表达进行检测。阳性表达细胞≤50%为低表达(L),>50%为高表达(H)。结果:1hr-HPV(16/18)DNA在ECA和EMA中的检出率分别为72.7%(24/33)和12.9%(4/31)。ECA中hr-HPV(16/18)DNA检出率显著高于EMA(P<0.01)。2在24例hr-HPV(16/18)DNA阳性的ECA病例中4种标记物组合有2种表达组型。其中23例(95.8%)呈p16(H)/Vim(L)/ER(L)/PR(L)表达类型,在9例hr-HPV(16/18)DNA阴性的ECA病例中,8例呈p16(L)/Vim(L)/ER(L)/PR(L)表达组型(88.9%)。3在27例hr-HPV(16/18)DNA阴性的EMA病例中,4种标记物组合有5种表达组型。其中21例(77.8%)为p16(L)/Vim(H)/ER(H)或/和PR(H)表达组型。在4例hr-HPV(16/18)DNA阳性EMA病例中,2例呈p16(H)/Vim(H)/ER(L)/PR(L)表达组型(50.0%),剩余2例(50.0%)分别为p16(H)/Vim(L)/ER(L)/PR(L)和p16(H)/Vim(H)/ER(H)/PR(H)表达组型。结论:hr-HPV(16/18)DNA检测和4种免疫标记物组合(p16,Vimentin,ER,PR)的不同表达组型在ECA和EMA的鉴别诊断中具有重要实用价值。

Value of hr-HPV (16/18) DNA Detection and Expression Patterns of a Four-Marker (p16, vimentin,ER and PR) Panel in the Differential Diagnosis of Primary Endocervical and Endometrial Adenocarcinomas

Objective:To evaluate the detections of hr-HPV(16/18)DNA and the common expression patterns of a four-marker(p16,vimentin,ER,PR)panel in the differential diagnosis of primary endocervical adenocarcinoma(ECA)and endometrial adenocarcinoma(EMA).Methods:The hrHPV(16/18)DNA and expression patterns of a four-marker(p16,vimentin,ER,PR)panel were detected in primary ECA and EMA by in situ hybridization and immunohistochemistry,re-spectively.Results:1The detection rate of hr-HPV(16/18)DNA in ECA was 72.7%(24/33),but was only 12.9%(4/31)in EMA.Statistical analysis showed that the detection rate of hrHPV(16/18)DNA in ECA was significantly higher than that in EMA(P<0.01).2In 24 cases of hr-HPV(16/18)DNA-positive ECA,the expression pattern of a four-marker panel was mainly p16(H)/Vim(L)/ER(L)/PR(L)(23/24;95.8%).The majority of the hr-HPV(16/18)DNA-negative ECA was p16(L)/Vim(L)/ER(L)/PR(L)(8/9,88.9%).3The expression patterns of the four-marker panel in 27 cases of hr-HPV(16/18)DNA-negative EMA were primarily p16(L)/Vim(H)/ER(H)/PR(H)(16/27;59.3%)and p16(L)/Vim(H)/ER(L)/PR(H)(5/27;18.5%).4In the 4cases of hr-HPV(16/18)DNA-positive EMA,p16(H)/Vim(H)/ER(L)/PR(L)was detected in 2cases(50.0%),p16(H)/vim(L)/ER(L)/PR(L)and p16(H)/Vim(H)/ER(H)/PR(H)was detected in the other 2cases(50.0%).Conclusion:Detections of hr-HPV(16/18)DNA and expression patterns of a four-marker(p16,vimentin,ER,PR)panel have an important value in the differential diagnosis of primary ECA and EMA.