宫颈病变组织中p16蛋白表达及其与人乳头瘤病毒感染的关系

目的探讨宫颈癌（cervicalcancer）及其癌前病变组织中p16蛋白表达及其与人乳头瘤病毒（humanpapillomavirus，HPV）感染的关系。方法采用免疫组化（immunohistochemistry，IHC）SP法检测40例宫颈浸润癌（invasivecarcinomaofcervix，ICC）标本（ICC组）、20例低度宫颈上皮内瘤样病变（cervicalintraepithelialneoplasiaI，CINI）标本（CINI组）、30例高度宫颈上皮内瘤样病变（CINⅡ～Ⅲ）（CINⅡ～Ⅲ组）标本和20例正常宫颈组织标本（对照组）的p16蛋白表达；用导流杂交基因芯片技术（HybriMax）测定上述标本的人乳头瘤病毒分型。结果P16蛋白在正常宫颈上皮（对照组）无表达，在宫颈癌及癌前病变组织呈现过表达（ICC组，CINI组，CINⅡ～Ⅲ组）；在CINI，CINII～HI，ICC组过表达率分别为35．0％，83．3％和100．0％。P16蛋白表达随宫颈病变级别进展而增加（P〈O．001）。高危人乳头状瘤病毒在正常宫颈上皮（对照组）的感染率为0，CINI，CINⅡ～Ⅲ，ICC组分别为55．0％，80．0％和92．5％。HPV一16和（或）一18亚型是宫颈癌及癌前病变最常见感染亚型。P16蛋白过表达在高危型人乳头瘤病毒（highriskhumanpapillomavirus，HR—HPV）感染宫颈组织明显高于HPV呈阴性或低危型人乳头瘤病毒（low—risk human papillomavirus，LRHPV）感染宫颈组织（P〈0．05）。结论P16蛋白过表达，可用于区分正常宫颈和宫颈癌前病变及宫颈浸润癌组织。P16蛋白过表达与高危型人乳头瘤病毒感染有关。

P16 Expression and Its Correlation With Human Papillomavirus Infection in Cervical Lesions

Objective To evaluate the expression and correlation among p16 protein, infection of human papillomavirus （HPV） in invasive cervix carcinoma （ICC） and cervical intraepithelial neoplasia （CIN）. Methods The immunohistochemical staining SP method was used to detect the expression of p16 protein and HybriMax was used to examine types of human papillomavirus in 40 cases of invasive carcinoma of cervix（ICC group） , 20 cases of CIN I （CIN I group） , 30 cases of CIN Ⅱ～Ⅲ （CIN Ⅱ～Ⅲ group） , and 20 cases of normal cervix tissues（control group）. Results （1）There was no positive expression of p16 protein in normal cervix tissues （control group）, but the over expression rates of CIN I group, CIN Ⅱ～Ⅲ group, and ICC group were 35.0%, 83.3%, and 100.0%, respectively. There was a significant trend of increasing expression from normal cervix or CIN I to invasive carcinoma of cervix （P〈0.05）. （2） The infection of high-risk human papillomavirus （HR-HPV） had been detected as negative in normal cervical samples, but 55.0% in CIN I group, 80.0% in CIN Ⅱ～Ⅲ group, 92. 5% in ICC group. HPV-16/-18 were predominant types （50%） of high risk human papillomavirus infection in cervical intraepithelial neoplasia and invasive carcinoma of cervix tissue samples. （3） There were significant positive correlations between the expression of p16 protein and high risk human papillomavirus in cervical intraepithelial neoplasia and invasive carcinoma of cervix tissue samples （P ~ 0. 05）. Conclusion Cervical intraepithelial neoplasia expresses p16 protein which has malignant proneness. The investigation of p16 protein may used as a supplementary test for screening and routine diagnosis of cervical lesions. The over expressions of p16 protein may related with high-risk human papillomavirus infection.