【摘要】 目的:研究cyclinE、p16ink4、ki67在宫颈脱落细胞中的表达水平及其与HPV16/18感染的相关性,探讨其对宫颈癌高危人群筛查的意义。方法:采用免疫组织化学方法对78例宫颈脱落细胞标本进行cyclinE、p16ink4、ki67检测,同时应用多重引物PCR技术检测HPV16/18。结果:cyclin E、p16ink4、ki67在宫颈癌细胞中的表达水平较ASCUS差异均有统计学意义(P<0.005);各级宫颈癌细胞中HPV16的阳性率较ASCUS差异均有统计学意义(x2=25.27,P<0.005),随着宫颈上皮细胞的损伤程度加重而阳性率升高,差异也有统计学意义(P<0.01)。p16ink4和ki67在宫颈癌细胞中的表达水平与HPV16高度相关(rs=1.0,P<0.05);而cyclinE的表达与HPV16相关性较小(rs=0.4,P<0.05)。HPV18的阳性例数较少,在各项分析中差异均无统计学意义(x2=3.68,P>0.05)。结论:cyclinE、p16ink4及ki67在宫颈癌细胞中的高度表达与HPV16感染有关,它们均可能作为有价值的诊断指标应用于宫颈癌高危人群筛查,且cyclinE对宫颈癌的早期诊断意义更大。更多还原

【Abstract】 Objective:To confirm the relations between the expression of cyclin E,p16ink4,ki67 and HPV_ 16/18 infection using cervical exfoliated cells,and evaluate the usefulness of cyclin E,p16ink4 and ki67 as biomarkers for screening of cervical carcionomas.Methods:The expression of cyclin E,p16ink4 oncoproteins and ki67 proliferative activity was evaluated immuohistochemically in 78 cervical exfoliated epithelial specimens.Human papillomavirus type 16 and 18(HPV_ 16/18) infection was assessed by polymerase chain reaction(PCR) using type specific primers.Results:Cyclin E,p16ink4 and ki67 were all overexpressed in cervical preneoplasia and neoplasia cells,compared with little expressed in ASCUS(P<0.005).Overexpression of cyclin E was observed in CIN_Ⅰ(P<0.01),p16ink4 and ki67 overexpressed in invasive carcinoma(100 % and 90.9 % respectively).The degree of p16ink4 and ki67 expression correlated well with the degree of cervical neoplasia (P<0.005).HPV_ 16 infection was assessed at all stages cervical neoplasia samples,and a significant relationship with the degree of cervical epithelial lession was observed at the same time.The expression level of p16ink4 and ki67 seemed to be more closely associated with HPV_ 16 infection than cyclin E did(r_s=1.0 vs r_s=0.4).HPV_ 18 was found positive in only 1 case in CIN_Ⅰ and 4 cases in CIN_ Ⅱ～Ⅲ.Therefore no significance was found on statistical analysis( P<0.005).Conclusion:Cyclin E,p16ink4 and ki67 should be regarded as useful biomarkers of HPV-related cervical neoplasias,and be used for screening patients at high risk of developing cervical carcinomas.Moreover,cyclin E might be a significant cytologic marker for the primary screening of cervical carcinomas.更多还原