Missaoui Nabiha, Hmissa Sihem, Sankaranarayanan Rengaswamy, Deodhar Kedar, Nene Bhagwan, Budukh Atul, Malvi Sylla, Chinoy Roshini, Kelkar Roshni, Kane Shubhada, Chauhan Madanmohan, Kothai Ashok, Kahate Smita, Fontanière Bernard, Frappart Lucien
Laboratoire central de pathologie, Hôpital Edouard Herriot, Lyon, France.
Ann Biol Clin (Paris). 2010 Jul-Aug;68(4):409-14. doi: 10.1684/abc.2010.0458.
The histological criteria of uterine cervix lesions are well known. However, there is a poor diagnostic reproducibility especially concerning low-grade precancerous lesions. Therefore, the aim of our study was to evaluate the utility of p16INK4A overexpression as a surrogate biomarker of precancerous lesions of the uterine cervix. A retrospective study was carried out by the International Center for Research on Cancer, Lyon, on 79 uterine cervix lesions. Specimens included 4 normal tissue samples, 24 benign lesions, 9 low-grade precancerous lesions (CIN1), 40 high-grade precancerous lesions (CIN2-3) and 2 squamous cell carcinomas. Immunohistochemistry was used to find p16INK4A expression. HPV infection was detected by HPV testing. No p16INK4A expression was detected in normal tissues and benign lesions of the uterine cervix. p16INK4A immunolabeling was weak in CIN1 cases (77.8%). Strong and diffuse p16INK4A expression was detected among all precancerous lesions (CIN2-3) and squamous cell carcinomas. p16INK4A overexpression was associated to the CIN grade (p<0.0001) and high-risk HPV infection (p<0.0001). In conclusion, p16INK4A overexpression should be regarded as a surrogate biomarker of precancerous lesions of the uterine cervix. p16INK4A overexpression is useful in reducing the variability during evaluation of suspicious biopsies of the uterine cervix.
子宫颈病变的组织学标准广为人知。然而，诊断的可重复性较差，尤其是在低级别癌前病变方面。因此，我们研究的目的是评估p16INK4A过表达作为子宫颈癌前病变替代生物标志物的效用。里昂国际癌症研究中心对79例子宫颈病变进行了一项回顾性研究。标本包括4例正常组织样本、24例良性病变、9例低级别癌前病变（CIN1）、40例高级别癌前病变（CIN2 - 3）和2例鳞状细胞癌。采用免疫组织化学法检测p16INK4A的表达。通过HPV检测来检测HPV感染。在子宫颈的正常组织和良性病变中未检测到p16INK4A表达。在CIN1病例中p16INK4A免疫标记较弱（77.8%）。在所有癌前病变（CIN2 - 3）和鳞状细胞癌中均检测到强而弥漫的p16INK4A表达。p16INK4A过表达与CIN分级（p<0.0001）和高危HPV感染（p<0.0001）相关。总之，p16INK4A过表达应被视为子宫颈癌前病变的替代生物标志物。p16INK4A过表达有助于减少子宫颈可疑活检评估过程中的变异性。
