p16、p53、BRAF、Bcl-2在卵巢浆液性肿瘤组织中的表达及临床意义

目的:探讨卵巢浆液性肿瘤组织中p16、p53、BRAF、Bcl-2的表达及临床意义。方法:收集宁夏医科大学总医院病理科2017年至2018年确诊的卵巢浆液性肿瘤136例，其中浆液性囊腺瘤52例，交界性囊腺瘤22例，低级别浆液性癌18例，高级别浆液性癌44例；另收集卵巢良性肿瘤和卵巢癌手术切除标本各30例。分别采用免疫组织化学SP法检测p16、p53、BRAF、Bcl-2的表达，实时定量PCR法检测p16、p53在卵巢良恶性肿瘤组织中的表达。结果:卵巢浆液性囊腺瘤、交界性囊腺瘤、低/高级别浆液性癌组织中p16的阳性率分别为3.8%、45.5%、88.9%、81.8%，p53为0、9.1%、55.6%、45.5%，BRAF为46.2%、45.5%、22.2%、31.8%，Bcl-2为46.2%、45.5%、38.9%、47.7%。不同类型浆液性肿瘤组织中p16、p53表达均有显著性差异（P＜0.001），但BRAF、Bcl-2表达未见明显差异。与卵巢良性肿瘤相比，p16在交界性肿瘤、卵巢癌中的阳性表达明显升高，差异有显著统计学意义（P＜0.012 5）；p53在卵巢癌中的阳性表达明显高于良性肿瘤（P＜0.001）；p16和p53的表达呈正相关（P＜0.05）。p53、Bcl-2与卵巢癌淋巴结转移有相关性（P＜0.001），p16、p53、Bcl-2与盆腔侵犯有关（P＜0.05），p53、BRAF、Bcl-2与CA125表达有不同程度相关性（P＜0.05）。p16、p53联合检测对卵巢癌诊断的敏感性和特异性为90.0%、76.7%。结论:p16、p53、BRAF、Bcl-2参与卵巢癌的发生发展，p16和p53基因突变可能在卵巢浆液性肿瘤的恶性进展中发挥作用，联合检测p16、p53对卵巢癌诊断有指示意义。

Expression and clinical significance of p16,p53,BRAF and Bcl-2 in serous ovarian neoplasm tissue

Objective:To investigate the expression and clinical significance of p16,p53,BRAF and Bcl-2 in serous ovarian neoplasm.Methods:136 specimens of serous ovarian neoplasm were collected from the Department of Pathology,General Hospital of Ningxia Medical University from 2017 to 2018,including 52 serous cystadenomas,22 borderline serous cystadenomas,18 low-grade serous carcinomas and 44 high-grade serous carcinomas.Another 30 cases of benign ovarian tumors and 30 cases of surgical resection of ovarian cancer were also collected.The expressions of p16,p53,BRAF and Bcl-2 were detected by immunohistochemical SP method,and the expression of p16，p53 in benign and malignant ovarian tumors were detected by real-time PCR,respectively.Results:The positive rates of p16 in ovarian serous cystadenoma,borderline cystadenoma,low-grade serous carcinoma and high-grade serous carcinoma were 3.8%,45.5%,88.9%,81.8%,and 0,9.1%,55.6%,45.5% for p53,and 46.2%,45.5%,22.2%,31.8% for BRAE and 46.2%,45.5%,38.9%,47.7% for Bcl-2,respectively.There were significant differences for the expression of p16 and p53 in different serous tumors (P＜0.001),but there was no significant difference for the expression of BRAF and Bcl-2.Compared with benign ovarian tumors,the positive expression of p16 in borderline tumors and ovarian cancer was significantly higher (P＜0.012 5).The positive expression of p53 in ovarian cancer was significantly higher than that in benign tumors (P＜0.001).There were positive correlation between p16 and p53 (P＜0.05).p53 and Bcl-2 were correlated with lymph node metastasis of ovarian cancer (P＜0.001).p16,p53 and Bcl-2 were associated with pelvic invasion (P＜0.05),and p53,BRAF and Bcl-2 were correlated with CA125 expression (P＜0.05).The sensitivity and specificity of p16 and p53 in the diagnosis of ovarian cancer were 90.0% and 76.7%.Conclusion:p16,p53,BRAF and Bcl-2 are involved in the occurrence and development of ovarian cancer.The mutations of p16 and p53 genes may play an important role in the malignant progression of serous ovarian neoplasm.The combined detection of p16 and p53 is of significance in the diagnosis of ovarian cancer.