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目的观察 p16~(INK4A)(简称 p16)蛋白在子宫颈腺癌和子宫内膜腺癌中的表达及其和高危型人乳头状瘤病毒 DNA(HPV DNA)在这两种腺癌中的鉴别诊断价值。方法用免疫组织化学EliVision 法检测30例子宫颈腺癌和10例子宫内膜腺癌中 p16蛋白的表达情况;并用原位杂交法检测20例子宫颈腺癌和10例子宫内膜腺癌中 HPV DNA。结果在30例子宫颈腺癌中21例 p16蛋白阳性(70%),而10例子宫内膜腺癌中3例为阳性。在子宫颈腺癌中 p16蛋白呈弥漫性细胞核和细胞质阳性,在子宫内膜腺癌中呈不规则斑点状阳性表达,而且总体强度较弱。HPV16和18在20例子宫颈腺癌中9例(45%)阳性,即细胞核内观察到点状棕黄色颗粒。10例子宫内膜腺癌均为阴性。结论鉴于 p16蛋白的表达模式比 HPV DNA 的检测敏感性高,且易于操作,故建议将其作为区分宫颈癌和子宫内膜腺癌的辅助指标,特别是在活检或诊刮时应增加 p16蛋白和 HPV DNA 的检测。
Objective To investigate the expression of p16 INK4A protein (p16) in cervical adenocarcinoma and endometrial adenocarcinoma and its relationship with high risk human papillomavirus DNA (HPV DNA) in both adenocarcinomas Diagnostic value. Methods The immunohistochemical EliVision method was used to detect the expression of p16 protein in 30 cases of cervical adenocarcinoma and 10 cases of endometrial adenocarcinoma. The HPV DNA of 20 cases of cervical adenocarcinoma and 10 cases of endometrial adenocarcinoma were detected by in situ hybridization . Results Of the 30 cervical adenocarcinomas, 21 had p16 protein positive (70%), whereas 10 of 10 endometrial adenocarcinomas were positive. In cervical adenocarcinoma p16 protein was diffuse nucleus and cytoplasm were positive in endometrial adenocarcinoma showed irregular spots positive expression, and the overall intensity is weak. HPV16 and 18 in 9 cases of cervical adenocarcinoma in 20 cases (45%) were positive, that is observed in the nucleus of brown particles. Ten cases of endometrial adenocarcinoma were negative. Conclusion As the expression pattern of p16 is more sensitive than the detection of HPV DNA and is easy to operate, it is suggested that p16 protein should be used as an auxiliary index to distinguish between cervical cancer and endometrial adenocarcinoma. In particular, p16 protein should be increased in biopsy or curettage And HPV DNA testing.