高危人乳头状瘤病毒和p53、p21WAF1、MDM2在子宫颈鳞癌中的表达

 目的 探讨子宫颈浸润性鳞状细胞癌（ISCC）中人乳头状瘤病毒（HPV）16／18、31／33 感染及p53、p21WAF1、双微体2（MDM2）蛋白的表达，研究其相关性及在ISCC发生、发展中的作用。方法 利用组织芯片、原位杂交和免疫组织化学法检测106例ISCC、10例子宫颈上皮内瘤变（CIN）、10例正常子宫颈鳞状上皮（NCE）中HPV16／18、31／33和p53、p21WAF1、MDM2的表达。应用SPSS12.5统计软件分析结果。结果 HPV16／18、p53、p21WAF1、MDM2在ISCC中的表达明显高于CIN和NCE组，差异有统计学意义；HPV31／33表达与淋巴结转移呈正相关（P＜0.05）；p53蛋白与组织学分级、淋巴结转移呈正相关；p21WAF1阳性表达率与子宫颈管壁浸润深度呈正相关；MDM2蛋白与临床各参数均无相关性（P＞0.05）。结论 高危HPV和突变型p53在ISCC的发生、发展中起重要作用，p53的下游基因MDM2作为癌基因在进展中起作用，而p21WAF1基因可能不是单纯作为抑癌基因在起作用。

Expression of high-risk HPV and p53, p21WAF1, MDM2 in cervical squamous cell carcinoma

Objective To determine the expression of HPV16/18, 31/33 DNA and p53, p21WAF1 and MDM2 proteins in invasive squamous cell carcinoma of cervix（ISCC）and to indicate the significance of them in the occurrence and development of ISCC. Methods Using tissue microarray, in situ hybridization (ISH) and immunohistochemical method, we detected the expression of HPV16/18, 31/33 and investigate the expres－sion of p53, p21WAF1, MDM2 and proteins in ISCC, CIN and NCE. Results was analysed by SPSS vision 12.5. Results The positive expression rate of HPV16/18, p53, p21WAF1, MDM2 in ISCC was markedly higher than in CIN and NCE. We found the difference between HPV31/33 and lymph node transfer. Significant relation－ship was observed between p53 protein expression and histological grade and lymph node metastasis of the cancer. There was positive correlation between the expression of p21WAF1 protein and the depth of invasion(P ＜0.05）. No significant correlation was observed between MDM2 protein expression and every clinical pathologi－cal parameters of ISCC. Conclusion High-risk HPV and mtp53 took an important effect in ISCC. MDM2 gene may play an important role as an oncogene on the occurrence in ISCC. p21WAF1 gene might not act as a suppressor-gene only on the occurrence in ISCC.