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目的探讨p16免疫组化染色和人乳头瘤病毒(HPV)DNA检测在鉴别宫颈腺癌(ECA)和子宫内膜腺癌(EMA)中的作用。方法 (1)采用免疫组化法检测41例ECA和72例EMA患者中p16的表达,采用着色范围和强度的半定量方法对结果进行评价,分析ECA和EMA患者中p16表达及与临床病理特征的关系。(2)杂交2代捕获法(HC-2)对41例ECA和46例EMA患者进行HPV DNA检测,分析二者的区别。结果 (1)p16在ECA和EMA的阳性率分别是97.5%(40/41)和80.6%(58/72),差异有统计学意义(P=0.009)。ECA患者中p16呈弥漫强阳性着色,EMA患者中则常呈局灶或斑片状着色。p16在ECA患者中的表达与淋巴结转移相关;p16在EMA患者中的表达与病理亚型、分化程度和国际妇产科协会(FIGO)分期有关。(2)ECA组中的HPV阳性率为22.0%(9/41),EMA组全部阴性,差异有统计学意义(P=0.001)。结论 p16和HPV检测对宫颈腺癌和宫内膜腺癌的鉴别有重要意义,可以为手术方式和治疗方案提供有价值的信息。
Objective To investigate the role of p16 immunohistochemistry and human papillomavirus (HPV) DNA in differentiating between cervical adenocarcinoma (ECA) and endometrial adenocarcinoma (EMA). Methods (1) Immunohistochemistry was used to detect the expression of p16 in 41 cases of ECA and 72 cases of EMA. The results were evaluated by semi-quantitative methods of color range and intensity. The expression of p16 in ECA and EMA patients was compared with the clinicopathological features Relationship. (2) Hybridization 2-generation capture method (HC-2) HPV DNA was detected in 41 cases of ECA and 46 cases of EMA, and the differences between the two were analyzed. Results (1) The positive rates of p16 in ECA and EMA were 97.5% (40/41) and 80.6% (58/72) respectively, with statistical significance (P = 0.009). In patients with ECA, diffuse and strongly positive staining of p16 was observed, while focal or patchy staining was often observed in patients with EMA. The expression of p16 in ECA patients is related to lymph node metastasis. The expression of p16 in EMA patients is related to the pathological subtype, differentiation degree and the FIGO staging. (2) The positive rate of HPV in ECA group was 22.0% (9/41), all negative in EMA group, the difference was statistically significant (P = 0.001). Conclusion The detection of p16 and HPV is of great significance for the identification of cervical adenocarcinoma and endometrial adenocarcinoma, which can provide valuable information for surgical methods and treatment options.