目的：分析子宫颈腺癌癌变过程中高危型人乳头状瘤病毒（HR-HPV）感染检测及P16INK4A蛋白表达的临床意义。方法2013年1月至2015年1月子宫颈微腺体增生患者25例、子宫颈原位腺癌患者65例、子宫颈浸润性腺癌患者24例，以及同期进行健康体检的慢性宫颈炎组织患者35例为观察对象。采用免疫组织化学方法检查组织中p16INK4A蛋白表达情况，并应用第二代杂交捕获法（HC-2）对13种HR-HPV DNA进行检测。结果子宫颈微腺体增生组织、原位腺癌及浸润性腺癌HR-HPV感染阳性率和P16INK4A蛋白表达阳性率均高于慢性宫颈炎组织（P<0.05）；宫颈组织中HR-HPV感染阳性率与P16INK4A蛋白表达表现为正相关性（P<0.05）。结论 HR-HPV导致宫颈恶化转化与P16INK4A蛋白表达密切相关，可以作为诊断子宫颈腺癌的辅助诊断指标，采用P16INK4A与HR-HPV联合诊断，有利于提高子宫颈癌及CIN阳性预测值，为临床疾病的诊断、治疗提供科学的参考依据。%Objective To analyze and discuss infection detection of papillomavirus(HR-HPV)of high risk type cervical adenocarcinoma and clinical significance of P16INK4A protein expression. Methods 25 cases of cervical intraepithelial neoplasia CIN Ⅰ,30 cases of CIN Ⅱ,35 cases of CIN Ⅲ,24 cases of infiltrating adenocarcinoma hospitalized from January 2013 to January 2014 in our hospital were selected,at the same time, 35 cases of normal cervical tissues(chronic inflammation)were selected,the expression of p16INK4A protein was detected by immunohistochemical method,and the 13 DNA HR-HPV was detected by the second generation hybrid capture(HC-2). Results The positive rates of CIN of cervical intraepithelial neoplasia,CINⅡ、CINⅢtissue,invasiveadenocarcinoma HR-HPV infection and the positive rate of P16INK4A protein expression were higher than those of normal cervical cells(P<0.05); HR-HPV infection positive ratein cervical tissues and P16INK4A protein expression were the positive correlation(P<0.05). Conclusions Papillomavirus(HR-HPV)of high risk patients leading to the transformation of cervical deterioration has a close relationship with the P16INK4A protein expression,it can be used as an auxiliary diagnosis index in diagnosis of cervical adenocarcinoma, using P16INK4A and HR-HPV to diagnose can improve positively predictive value of cervical cancer and CIN,and it can provide scientific basis for the diagnosis and treatment of clinical diseases.
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