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恶性肿瘤中 p16 染色的高发生率。

High prevalence of p16 staining in malignant tumors.

机构信息

Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany.

出版信息

PLoS One. 2022 Jul 21;17(7):e0262877. doi: 10.1371/journal.pone.0262877. eCollection 2022.

Abstract

p16 (CDKN2A) is a member of the INK4 class of cell cycle inhibitors, which is often dysregulated in cancer. However, the prevalence of p16 expression in different cancer types is controversial. 15,783 samples from 124 different tumor types and 76 different normal tissue types were analyzed by immunohistochemistry in a tissue microarray format. p16 was detectable in 5,292 (45.0%) of 11,759 interpretable tumors. Except from adenohypophysis in islets of Langerhans, p16 staining was largely absent in normal tissues. In cancer, highest positivity rates were observed in uterine cervix squamous cell carcinomas (94.4%), non-invasive papillary urothelial carcinoma, pTaG2 (100%), Merkel cell carcinoma (97.7%), and small cell carcinomas of various sites of origin (54.5%-100%). All 124 tumor categories showed at least occasional p16 immunostaining. Comparison with clinico-pathological data in 128 vulvar, 149 endometrial, 295 serous ovarian, 396 pancreatic, 1365 colorectal, 284 gastric, and 1245 urinary bladder cancers, 910 breast carcinomas, 620 clear cell renal cell carcinomas, and 414 testicular germ cell tumors revealed only few statistically significant associations. Comparison of human papilloma virus (HPV) status and p16 in 497 squamous cell carcinomas of different organs revealed HPV in 80.4% of p16 positive and in 20.6% of p16 negative cancers (p<0.0001). It is concluded, that a positive and especially strong p16 immunostaining is a feature for malignancy which may be diagnostically useful in lipomatous, urothelial and possibly other tumors. The imperfect association between p16 immunostaining and HPV infection with high variability between different sites of origin challenges the use of p16 immunohistochemistry as a surrogate for HPV positivity, except in tumors of cervix uteri and the penis.

摘要

p16(CDKN2A)是 INK4 细胞周期抑制剂家族的成员,其在癌症中经常失调。然而,p16 在不同癌症类型中的表达率存在争议。通过免疫组织化学组织微阵列格式分析了来自 124 种不同肿瘤类型和 76 种不同正常组织类型的 15783 个样本。在 11759 个可解释的肿瘤中,有 5292 个(45.0%)可检测到 p16。除胰岛中的腺垂体外,p16 染色在正常组织中基本不存在。在癌症中,子宫颈鳞状细胞癌(94.4%)、非浸润性乳头状尿路上皮癌 pTaG2(100%)、默克尔细胞癌(97.7%)和各种起源的小细胞癌(54.5%-100%)的阳性率最高。所有 124 种肿瘤类型均至少偶尔显示出 p16 免疫染色。与 128 例外阴、149 例子宫内膜、295 例浆液性卵巢、396 例胰腺、1365 例结直肠、284 例胃和 1245 例膀胱癌、910 例乳腺癌、620 例透明细胞肾细胞癌和 414 例睾丸生殖细胞肿瘤的临床病理数据进行比较,仅发现少数具有统计学意义的关联。对 497 种不同器官的鳞状细胞癌的人类乳头瘤病毒(HPV)状态和 p16 进行比较,发现 HPV 在 p16 阳性癌中的比例为 80.4%,在 p16 阴性癌中的比例为 20.6%(p<0.0001)。因此,阳性和尤其是强 p16 免疫染色是恶性肿瘤的特征,这在脂肪性、尿路上皮性和可能其他肿瘤中可能具有诊断价值。p16 免疫染色与 HPV 感染之间的不完全关联以及不同起源部位之间的高度变异性,使得 p16 免疫组织化学作为 HPV 阳性的替代物的应用受到挑战,除非在子宫颈和阴茎的肿瘤中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec3e/9302831/22c158abcced/pone.0262877.g001.jpg

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