Xu Ting, Lu Hui-Juan, He Yi-Feng
Deparment of Pathology, First Maternity and Infant Hospital, Shanghai 200040, China.
Zhonghua Zhong Liu Za Zhi. 2008 Mar;30(3):211-4.
In cervical lesions, the overexpression of p16INK4a has been reported to be closely associated with human papillomavirus (HPV) infection. This study is designed to evaluate the role of p16INK4a as a biomarker in liquid-based cervical cytology screening.
Seventy-four specimens from the patients in our hospital were collected for this study. After cytological examination with liquid-based cervical smears, high-risk HPV (HR-HPV) DNA was then detected by Hybrid Capture II assay, and the rest cells were immunostained for p16INK4a.
Of the 74 specimens, 10 were diagnosed as negative, 15 as atypical squmous cells of undetermined significance (ASC-US), 28 as low-grade squamous intraepithelial lesion (LSIL), 5 as atypical squmous cells which could not be excluded as HSIL (ASC-H), 11 high-grade squamous intraepithelial lesion (HSIL) and 5 as squamous cell carcinoma (SCC). The positive specimens of p16INK4a were 2, 5, 8, 3, 9, 5, respectively, in the above subgroups; meanwhile, the positive specimens of HR-HPV were 1, 4, 9, 3, 7, 5, respectively, in the above groups. The positive rate of both p16INK4a and HR-HPV in HSIL, ASC-H and SCC were obviously higher than that in LSIL, ASC-US and negative cases.
Positive rate of p16INK4a and HR-HPV is highly correlated with the grade of the cervical lesion. p16INK4a immunocytochemical staining may be used as a biomarker to increase the sensitivity of cervical cytology screening and the specificity of HPV test.
在宫颈病变中,据报道p16INK4a的过表达与人乳头瘤病毒(HPV)感染密切相关。本研究旨在评估p16INK4a作为生物标志物在液基宫颈细胞学筛查中的作用。
收集我院74例患者的标本用于本研究。采用液基宫颈涂片进行细胞学检查后,通过杂交捕获II检测法检测高危型HPV(HR-HPV)DNA,其余细胞进行p16INK4a免疫染色。
74例标本中,10例诊断为阴性,15例为意义不明确的非典型鳞状细胞(ASC-US),28例为低级别鳞状上皮内病变(LSIL),5例为不能排除高级别鳞状上皮内病变的非典型鳞状细胞(ASC-H),11例为高级别鳞状上皮内病变(HSIL),5例为鳞状细胞癌(SCC)。上述亚组中p16INK4a阳性标本分别为2、5、8、3、9、5例;同时,上述组中HR-HPV阳性标本分别为1、4、9、3、7、5例。HSIL、ASC-H和SCC中p16INK4a和HR-HPV的阳性率明显高于LSIL、ASC-US和阴性病例。
p16INK4a和HR-HPV的阳性率与宫颈病变分级高度相关。p16INK4a免疫细胞化学染色可作为一种生物标志物,提高宫颈细胞学筛查的敏感性和HPV检测的特异性。