宫颈鳞状上皮病变组织中乳头状瘤病毒和Ki-67及p16^INK4a蛋白表达意义的研究

目的：探讨Ki-67、p16^INK4a和人乳头状瘤病毒（HPV）在不同程度宫颈鳞状上皮病变组织中的表达及临床病理意义。方法：采用原位分子杂交及免疫组化方法,检测HPV的不同亚型、Ki-67、p16^INK4a蛋白在182例不同程度宫颈病变组织中的表达。结果：HPV在不同程度病变中总检出率52.19%（95/182）;在宫颈高级别上皮内瘤变及鳞癌组中检出最多的感染类型为HPV16/18,而HPV6/11在尖锐湿疣组检出率87.50%（21/24）最高;随着宫颈病变严重程度的增加,级别升高,Ki-67、p16^INK4a阳性程度呈递增趋势。Ki-67、p16^INK4a与HPV16/18型感染关系密切,χ^2=11.779 8,P〈0.01;Ki-67也与HPV6/11型有关。结论：HPV16/18型及Ki-67、p16^INK4a在宫颈高级别上皮内瘤变及鳞癌中表达明显升高,可能对宫颈鳞癌的发生、发展具有协同作用。

Expressions of Ki-67 p16^INK4a and HPV in squamous cell lesions of cervix tissues

OBJECTIVE： To explore the clinicopathologic significance of the Ki-67,p16^INK4a and humen papilloma virus（HPV） expressions in the diseased cervical tissues with different degrees of severity.METHODS： Situ hybridisation and immunonhistochemistry were used to detect the expressions of the different subtypes of HPV,Ki-67 and p16^INK4a in 182 cases of the diseased cervix tissues with diffrent degrees of severity.RESULTS： The positive rate of HPV in all specimens was 52.19%（95/182）.HPV16/18 was mostly detected in the group of cervical high-grade intraepithelial neoplasia and cervical squamous cell carcinoma.The positive rate of HPV6/11（87.50%,21/24） was the highest in the group of condyloma acuminatum.The positive rates and sataining intensity of p16^INK4a and Ki-67 increased with the severity of diseased cervical tissues.There was a close correlation between the expressions of p16^INK4a,Ki-67 and HPV16/18 infection（χ^2=11.779 8,P〈0.01）,and HPV6/11（87.50%,21/24） infection was associated with the expression of Ki-67.CONCLUSION： The expressions of HPV16/18,p16^INK4a and Ki-67 increased obviously in cervical high-grade intraepithelial neoplasia and cervical squamous cell carcinoma,and they may paly a conjunctive role in the pathogenesis and development of cerviacal squamous cell carcinoma.