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目的 :为了探明抑癌基因 P16在子宫平滑肌瘤发生发展中的作用及其在诊断中的临床意义。方法 :应用细胞免疫荧光技术及流式细胞术 ,对 5 5例子宫平滑肌肿瘤石蜡组织块的 P16表达定量分析。结果 :正常子宫平滑肌组织 P16表达均为阴性。 14例平滑肌瘤仅 2例出现过度表达 (14 % ) ;交界性平滑肌肿瘤 12例 ;多数为过度表达 (75 % ) ;平滑肌肉瘤 2 9例中 ,则有 2 7例 (93 % )出现过度表达。从平滑肌瘤、交界性平滑肌瘤到平滑肌肉瘤 ,P16表达量显著递增。P16表达量随肿瘤细胞分裂相、异形性、密度的增高也有明显增高。P16低表达者 5年生存率为 85 % ,而过度表达者为 4 8.5 %。结论 :子宫平滑肌肿瘤一旦出现 P16过度表达应考虑为恶性 ;P16表达可能和平滑肌瘤向平滑肌肉瘤的转化密切相关 ,P16表达可作为判断病人预后的一项客观指标。
Objective: To investigate the role of tumor suppressor gene P16 in the development of uterine leiomyoma and its clinical significance in the diagnosis. Methods: Quantitative analysis of P16 expression in 5 5 cases of uterine smooth muscle tumor paraffin blocks was performed by immunofluorescence and flow cytometry. Results: The normal uterine smooth muscle tissue P16 expression were negative. Of the 14 cases of leiomyoma, only 2 cases showed overexpression (14%), 12 cases of borderline smooth muscle tumors (mostly 75%) and 2 cases (93%) of 29 cases of leiomyosarcoma were overexpression expression. From leiomyoma, borderline leiomyoma to leiomyosarcoma, P16 expression increased significantly. P16 expression with the tumor cell division phase, heterotypic, increased density also significantly increased. The 5-year survival rate of P16 low expression was 85%, while that of overexpression was 48.5%. Conclusion: P16 overexpression in uterine smooth muscle tumors should be considered malignant. The expression of P16 may be closely related to the leiomyosarcoma transformation to leiomyosarcoma. The expression of P16 may be used as an objective index to judge the prognosis of patients.