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目的探讨原发宫颈腺癌癌变过程中Cyclin D1及P16的表达及临床意义。方法回顾性分析江门市中心医院2005年1月—2014年10月经手术切除的宫颈腺癌患者的临床病理资料,采用免疫组织化学SP法检测82例宫颈腺癌、92例宫颈腺上皮内肿瘤形成(cervical glandular intraepithelial neoplasia,CGIN)及24例正常宫颈组织中Cyclin D1与P16蛋白水平的变化,推测其与宫颈腺癌的发生发展及分化程度的关系,判断患者是否存在淋巴结微转移的可能性。结果 Cyclin D1在原发宫颈腺癌、CGIN和正常宫颈腺上皮中的阳性表达率分别为82.93%、52.17%和16.67%,三组间差异有统计学意义(P<0.05);上述三种组织中P16的阳性表达率分别为31.71%、54.35%和91.67%,差异有统计学意义(P<0.05)。Cyclin D1与P16蛋白表达水平的变化与宫颈腺癌细胞分化程度及淋巴结转移存在相关性(P<0.05),与临床分期及年龄无明显相关(P>0.05)。结论 Cyclin D1及P16蛋白可能在宫颈腺癌的发生发展过程中起重要作用,可以作为判断预后的指标,用于评估及指导治疗。
Objective To investigate the expression of Cyclin D1 and P16 in primary cervical carcinogenesis and its clinical significance. Methods The clinical and pathological data of patients with cervical adenocarcinoma who underwent surgical resection from January 2005 to October 2014 in Central Hospital of Jiangmen were retrospectively analyzed. The immunohistochemical SP method was used to detect 82 cases of cervical adenocarcinoma and 92 cases of cervical intraepithelial neoplasia (cervical glandular intraepithelial neoplasia CGIN) and 24 cases of normal cervical tissue Cyclin D1 and P16 protein levels, speculated that cervical adenocarcinoma with the occurrence and development of the relationship between the degree of differentiation to determine whether patients with lymph node micrometastasis possibility. Results The positive rates of Cyclin D1 expression in primary cervical adenocarcinoma, CGIN and normal cervical epithelium were 82.93%, 52.17% and 16.67%, respectively, with significant differences among the three groups (P <0.05). The above three tissues The positive expression rate of P16 was 31.71%, 54.35% and 91.67%, respectively, with significant difference (P <0.05). The changes of Cyclin D1 and P16 protein expression were correlated with the degree of cervical adenocarcinoma cell differentiation and lymph node metastasis (P <0.05), but not with clinical stage and age (P> 0.05). Conclusion The expressions of Cyclin D1 and P16 proteins may play an important role in the development of cervical adenocarcinoma and can be used as an index to judge the prognosis for the assessment and guidance of treatment.