宫颈原发性浸润性腺癌临床病理分析

目的研究癌胚抗原（CEA）、抑癌基因p16蛋白和p53蛋白、增殖细胞抗原（Ki-67）抗体在原发性宫颈腺癌组织中的表达及临床病理特点。方法用快捷免疫组织化学染色法检测27例宫颈腺癌患者（腺癌组）和18例宫颈腺体增生患者（对照组）组织中CEA、p16、p53、Ki-67的表达，分析比较2组免疫组织化学标记情况，统计分析临床资料。结果腺癌组CEA、p16和p53的阳性表达分别是25例（92．6％）、23例（85．2％）和19例（70．4％），Ki-67高表达16例（59．3％）；对照组CEA、p16、p53、Ki-67均为阴性，2组相比各项指标的表达率差异均有统计学意义（均P〈0．05）。结论CEA、p16、p53阳性和Ki-67高表达，提示为恶性病变。CEA、p16、p53、Ki-67联合应用在宫颈腺癌的鉴别诊断中有重要参考价值。

Pathological manifestations of primary invasive cervical adenocarcinoma

Objective By correlating expressions of CEA, p16, p53 and Ki-67 molecules with pathological features of primary cervical adenocarcinoma, we aim to observe early diagnosis of this type of tumor. Methods Using immunohistochemistry (IHC), we examined the expressions of CEA, p16, p53 and Ki-67 molecules in 27 cases of primary cervical adenocarcinoma and 18 cases of hyperplasic endocervical glands collected from 2003 to 2007. The expression levels in tumor and hyperplasic groups were semi-quantified and analyzed statistically. Results In primary cervical adenocarcinoma group, the positive rates of CEA, p16,p53 and Ki-67 were 92.6%, 85.2%, 70.4% ,and 59.3% respectively, significantly higher (P <0.05) than those of the hyperplasic endocervical gland group. The cases of the primary cervical adenocarcinoma showed some common clinical features including excessive virginal discharges, bleeding, enlargement and hardening of the cervix. Conclusion Over-expression of CEA, p16, p53 and Ki-67 in cervical tissues may indicate malignant alterations. IHC analysis of CEA, p16, p53 and Ki-67 in cervical biopsies and gross examination of the cervix for signs of excessive discharges, bleeding, enlargement and hardening can assist early diagnosis of primary cervical adenocarcinoma.