P16蛋白检测在子宫颈腺癌和子宫内膜腺癌鉴别诊断.docVIP

　　P16蛋白检测在子宫颈腺癌和子宫内膜腺癌鉴别诊断 【摘要】 目的 观察p16蛋白在子宫颈腺癌和子宫内膜腺癌中的表达及其在鉴别诊断中的意义。同时亦可指导临床上的部分早期病例是否需保留生育功能。方法 用免疫组织化学SP法检测40例子宫颈腺癌和73例子宫内膜腺癌中p16、p53、ER及PR的表达情况。结果 （1）p16在40例子宫颈腺癌中有37例（92.5 %）呈弥漫阳性，在73例子宫内膜腺癌中28例（38.4%）呈灶性阳性。（2）在子宫颈腺癌中p53、ER、PR阳性表达各占20.0%、5.0%、7.5 %，而在子宫内膜腺癌中p53有38.4%表达阳性，激素受体ER、PR在子宫内膜腺癌中分别有78.1%、71.2%表达。在子宫颈腺癌中p16蛋白呈弥漫性细胞核和细胞质阳性，而组织学形态与其相似的宫内膜腺癌中呈不规则灶性阳性，而且总体强度较弱。p16蛋白检测同时联合p53蛋白检测、激素受体ER、PR不但可鉴别子宫颈腺癌和子宫内膜腺癌，还可用于子宫浆液性腺癌和子宫内膜样腺癌鉴别诊断。结论 对活检或诊刮子宫腺癌标本，选用p16蛋白检测可以作为一个辅助性免疫组织化学标记物来鉴别子宫颈腺癌和子宫内膜腺癌。 【关键词】 子宫颈腺癌 子宫内膜腺癌 p16 鉴别诊断 【Abstract】 Objective:TObjectives Observation of p16 protein in cervical adenocarcinoma and endometrial cancer in the differential diagnosis of significance. Also part of the guideline on early cases munohistochemistry assay for the detection of cervical adenocarcinoma and 40 examples of 73 cases of endometrial carcinoma p16, p53, ER and PR of the expression. Results (1) the p16 in 40 examples of cervical adenocarcinoma in 37 cases (92.5%) is diffuse and positive, in 73 cases of endometrial carcinoma in 28 patients (38.4%) is of positive. (2) in cervical adenocarcinoma in p53, ER, PR positive expression of various 20.0% and 5.0% and 7.5%, etrial cancer in p53 38.4% overexpression, Hormone receptor ER, PR in endometrial cancer respectively 78.1% and 71.2% expression. In cervical adenocarcinoma p16 protein in the diffuse nuclear and cytoplasmic-positive, and histological forms resemble endometrial carcinoma irregular of positive, and the overall strength is loa p16 protein displayed prevalent, the strength of expression in to, and histological forms resemble endometrial carcinoma is the one receptor ER, PR a and endometrial cancer, can also be used for uterine serous carcinoma and endometrial cancer diagnosis. Conlusions Consultation on biopsy or scraping of uterine cancer samples, selection of p16 protein detection can be used as an auxiliary immunocytochemistry to identification of cervical adenocarcinoma and endometrial cancer. 【Key a of cervix