Izaaks Christo D, Truter Ernest J, Khan Sehaam
Address: Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology (CPUT), Bellville Campus, Cape Town 7535, Western Cape, Republic of South Africa.
Cytojournal. 2012;9:19. doi: 10.4103/1742-6413.100123. Epub 2012 Aug 25.
Previous studies demonstrated the etiological role of human papilloma virus (HPV) in cervical carcinogenesis. Assessing the distribution of HPV may elucidate these observations.
In total, we examined 3839 specimens, of which 187 abnormally classified cervical smears were immunostained using the p16(INK4A) assay. DNA was extracted from 182 specimens, and polymerase chain reaction (PCR) was performed. Participants' socio-demographics, sexual and reproductive history, HIV status, contraceptive use, and Pap smear history were recorded.
Subject ages, number of sexual partners, and age at first sexual encounter ranged from 15 to 49 years, from 1 to 37 partners, and from 13 to 34 years, respectively. P16 immunoreactivity was detected in 60.4% of cases. The distribution of epithelial lesions and P16 overexpression (bracketed) was: 28 (5) atypical squamous cells of undetermined significance (ASC-US), 96 (50) lower grade squamous intraepithelial lesion (LSIL), 9 (7) atypical squamous cells-cannot exclude HSIL (ASC-H), and 54 (51) higher grade squamous intraepithelial lesion (HSIL). Ninety-four percent of HSIL expressed P16. Fifty-two percent of LSIL expressed P16. P16 expression declined from 61% (25-34 year age group) to 5% (45-49 year age group) for different age groups. HPV-DNA by PCR was detected in 94.5% of P16-positive samples. Type-specific PCR (HPV 16 and 18) was found in 12.2% and 14.5% of abnormal lesions, respectively. Younger age at first sexual encounter and HIV infection predominated in HPV type(s) 16 and/or 18 positive subjects.
This study reinforced the value of the p16(INK4A) surrogate marker in identifying women with progressive cervical disease.
既往研究证实人乳头瘤病毒（HPV）在宫颈癌发生中的病因学作用。评估HPV的分布情况可能会阐明这些观察结果。
我们总共检查了3839份标本，其中187份异常分类的宫颈涂片采用p16（INK4A）检测法进行免疫染色。从182份标本中提取DNA，并进行聚合酶链反应（PCR）。记录参与者的社会人口统计学特征、性与生殖史、HIV感染状况、避孕措施使用情况以及巴氏涂片史。
受试者年龄、性伴侣数量以及首次性接触年龄分别为15至49岁、1至37个伴侣以及13至34岁。60.4%的病例检测到p16免疫反应性。上皮病变和p16过表达（括号内）的分布情况为：28例（5例）意义不明确的非典型鳞状细胞（ASC-US）、96例（50例）低级别鳞状上皮内病变（LSIL）、9例（7例）非典型鳞状细胞-不能排除高级别鳞状上皮内病变（ASC-H）以及54例（51例）高级别鳞状上皮内病变（HSIL）。94%的HSIL表达p16。52%的LSIL表达p16。不同年龄组中，p16表达从61%（25-34岁年龄组）降至5%（45-49岁年龄组）。PCR检测发现94.5%的p16阳性样本中存在HPV-DNA。在12.2%和14.5%的异常病变中分别发现了型特异性PCR（HPV 16和18）。HPV 16和/或18阳性受试者中首次性接触年龄较小和HIV感染情况较为常见。
本研究强化了p16（INK4A）替代标志物在识别进展性宫颈疾病女性中的价值。
