摘要目的 研究乳头瘤病毒衣壳蛋白(HPVL1)及p16INK4A基因在子宫颈病变患者中的表达与相关性.方法 采用免疫组织化学Max-Vision法检测210例HPV阳性液基细胞学标本及组织中HPV L1蛋白及p16INK4A的表达.结果 在各级液基细胞学标本中,HPVL1蛋白阳性率各组比较差异有统计学意义(x2=70.50、P＜0.005),其中低度鳞状上皮内病变(LSIL)组最高[68％(34/50)];p16INK4A表达阳性率随着病变级别的增高逐渐增高(13％、28％、52％、100％、100％),在子宫颈癌(SCC)组最高[100％(30/30)].HPVL1+p 16INK4A-率在LSIL组中最高[32％(16/50)]；HPVL1-p16INK4A+率在SCC组最高[100％(30/30)].在各级别病理组织中,HPVL1蛋白表达阳性率不同,差异有统计学意义(x2=54.37、P＜ 0.005),其中,CIN Ⅰ级中最高[60.4％(32/53)];p16INK4A表达阳性率随着病变级别的增高逐渐增高,在子宫颈癌组最高[100％(28/28)].HPVL1+p16-率在CIN Ⅰ级中最高[45.3％(24/53)]；HPVL1-p16+率在子宫颈癌中最高[100％(28/28)].结论 HPVL1蛋白与p16INK4A联合检测可以区分不同的子宫颈病变,将有潜在发展与有自愈可能的病例分开,避免漏诊与过度治疗.

abstractsObjective To observe the expression and relevance of human papillomavirus L1 (HPVL1)capsid protein and tumor suppressor gene p16~4A in cervical lesions.Methods The expression of HPVL1 capsid protein and p16INK4A in liquid-based cytology specimens and organization from 210 cases infected with HPV virus were detected by Max-vision immunohistochemistry method.Results In different grade of liquidbased cytology specimens,the positive rates of HPVL1 capsid protein had statistic difference (x 2 =70.50,P ＜ 0.005).The rate in LSIL couples was 68 ％ (34/50),which was the highest in all couples.The positive rates of tumor suppressor gene p16INK4A were increased gradually.In SCC couples,the positive rates was 100 ％(30/30),which was the hishest.In LISL couples,the rate of HPVL1+ p16INK4A-was 32 ％ (16/50),which was the hishest.In SCC couples,the rate of HPVL1-p16INK4A+ was 100 ％ (30/30),which was the highest.In orgnizational specimens,the positive rates of HPVL1 capsid protein in cervical intraepithelial neoplasia had statistic difference (x2 =54.37,P ＜ 0.005).The rate in CIN Ⅰ group was 60.4 ％ (32/53),which was the highest.The positive rates of tumor suppressor gene p16 were increased gradually.In cervical cancer group,the positive rate was 100 ％ (28/28),which was the highest.In CIN Ⅰ group,the rate of HPVL1+ p16INK4A-was 45.3 ％ (24/53),which was the highest.In cervical cancer couples,the rate of HPVL1 (-) p16INK4A(+) was 100 ％ (28/28),which was the highest.Conclusion Detection on the expression of HPVL1 capsid protein and tumor suppressor gene p16INK4A can diverse different levels of cervical lesions and separate cases from aggravated or self-healing,to avoid over-treatment or misdiagnose.