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[免疫组织化学检测p16和GATA3及分子HPV分型在宫颈癌继发膀胱受累诊断中的应用]

[Application of immunohistochemistry for p16 and GATA3 and molecular HPV typing in diagnosis of secondary bladder involvement by cervical carcinoma].

作者信息

Huang R F, He C, Zhu W F, Li Y, Chen G

机构信息

Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2017 Jun 8;46(6):388-392. doi: 10.3760/cma.j.issn.0529-5807.2017.06.005.

Abstract

To investigate the expression of p16 and GATA3 and the detection of human papillomavirus (HPV) in secondary bladder involvement by cervical carcinomas. Sixteen cases of cervical carcinoma with bladder involvement diagnosed from December 2008 to March 2016 were collected and evaluated by light microscopy, immunohistochemistry for p16 and GATA3 detection and PCR-reverse dot blot for molecular typing of HPV. The age of the patients ranged from 25 to 76 years with median of 52 years. Morphologically, 14 cases(14/16) showed tumor nests infiltrating lamina propria or muscle bundles of the bladder. By immunohistochemistry, 15 cases (15/16) were found to be diffusely and strongly positive for p16, and 1 showed patchy staining pattern. Seven cases (7/7) of corresponding original cervical cancers were also diffusely and strongly positive for p16. GATA3 staining was negative in 13 cases (13/16), and focal weak to moderate positivity was detected in 3 cases.Three cases (3/7) of corresponding original cervical cancers showed focal weak to moderate positivity of GATA3. Fifteen cases (15/16) showed concordant high risk HPV-positivity, including HPV16 in 8 cases and HPV31 in one case. Five cases showed co-infection of HPV16 and HPV18. One case showed co-infection with HPV18 and HPV45. Differential diagnosis by p16 or GATA3 alone is of limited value. Combination of immunohistochemistry for p16 and GATA3 and molecular typing for HPV detection are useful to distinguish primary bladder carcinoma from the secondary involvement by cervical carcinoma.

摘要

探讨宫颈癌继发膀胱受累时p16和GATA3的表达及人乳头瘤病毒(HPV)的检测情况。收集2008年12月至2016年3月诊断为宫颈癌继发膀胱受累的16例病例,通过光学显微镜、检测p16和GATA3的免疫组织化学以及HPV分子分型的PCR反向斑点杂交进行评估。患者年龄为25至76岁,中位年龄52岁。形态学上,14例(14/16)显示肿瘤巢浸润膀胱固有层或肌束。免疫组织化学显示,15例(15/16)p16弥漫性强阳性,1例呈斑片状染色模式。相应原发性宫颈癌的7例(7/7)p16也弥漫性强阳性。13例(13/16)GATA3染色阴性,3例检测到局灶性弱阳性至中度阳性。相应原发性宫颈癌的3例(3/7)显示GATA3局灶性弱阳性至中度阳性。15例(15/16)显示高危HPV阳性一致,其中8例为HPV16,1例为HPV31。5例显示HPV16和HPV18合并感染。1例显示HPV18和HPV45合并感染。单独通过p16或GATA3进行鉴别诊断价值有限。p16和GATA3免疫组织化学联合HPV检测分子分型有助于区分原发性膀胱癌和宫颈癌继发膀胱受累。

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