基于 P16INK4a 免疫组化的 HPV 相关型与 HPV 非相关型宫颈癌的临床病理特征比较分析：一项为期一年的回顾性研究。

A comparative analysis of clinicopathological features of HPV-associated and HPV-independent cervical carcinomas based on P16 INK4a immunohistochemistry: A one-year retrospective study.

机构信息

Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India.

Department of Pathology, Siddhartha Medical College, Guntur, Andhra Pradesh, India.

出版信息

Indian J Pathol Microbiol. 2024 Jan-Mar;67(1):74-79. doi: 10.4103/ijpm.ijpm_700_22.

DOI:10.4103/ijpm.ijpm_700_22

PMID:38358192

Abstract

UNLABELLED

The recent WHO classification of female genital tracts recommends cervical carcinomas to be further subtyped as HPV-associated and HPV-independent and accepted p16 immunoreactivity as a surrogate biomarker for HPV testing. This paper presents the clinicopathological spectrum of cervical carcinomas in correlation with p16 immunoreactivity.

AIMS AND OBJECTIVES

This study aims to evaluate the immunoreactivity of p16 in cervical carcinoma, subtype them into HPV-associated and HPV-independent based on p16 immunoreactivity, and correlate them with clinicopathological features.

DESIGN

A hospital-based retrospective study of one-year duration was done after ethics approval. A total of 124 cases were identified, and various parameters like the presence of mitosis, lymphovascular invasion, tumor budding, tumor-infiltrating lymphocytes, the pattern of stromal invasion, and the pattern of necrosis were recorded and graded. Immunohistochemistry (IHC) with p16 marker was done in 40 cases, and immunoreactivity was correlated with clinical and histopathological parameters.

STATISTICAL ANALYSIS

Multivariate analysis was done with Fisher's exact test, and a P value of <0.05 was considered significant.

RESULTS

P16 was positive in 36 out of 40 cases which included 35 cases of squamous cell carcinoma (SCC) (keratinizing-14 out of 35 SCC, 11 positive out of these 14, non-keratinizing-21 out of 35 SCC, 20 positive, out of these 21), two cases of adenocarcinoma (both positive), two cases of adenosquamous carcinoma (both positive), and one case of small cell neuroendocrine carcinoma (positive). p16 negative in four cases (10%) (keratinizing type-3, non-keratinizing-1). P value was significant for HPV-independent carcinoma and keratinizing SCC morphology. The P value was not significant when p16 positivity with other parameters.

CONCLUSION

HPV-associated were 90%, HPV-independent were 10%.

摘要

未加标签

最近世界卫生组织（WHO）对女性生殖器官肿瘤的分类建议将宫颈癌进一步分为 HPV 相关型和 HPV 非相关型，并接受 p16 免疫反应作为 HPV 检测的替代生物标志物。本文介绍了与 p16 免疫反应相关的宫颈癌的临床病理谱。

目的

本研究旨在评估宫颈癌中 p16 的免疫反应，根据 p16 免疫反应将其分为 HPV 相关型和 HPV 非相关型，并与临床病理特征相关联。

设计

本研究是在获得伦理批准后进行的为期一年的医院回顾性研究。共确定了 124 例病例，记录并分级了各种参数，如存在有丝分裂、脉管侵犯、肿瘤芽生、肿瘤浸润淋巴细胞、基质浸润模式和坏死模式。对 40 例病例进行了 p16 标志物的免疫组织化学（IHC）检测，并将免疫反应与临床和组织病理学参数相关联。

统计学分析

采用 Fisher 精确检验进行多变量分析，P 值<0.05 认为具有统计学意义。

结果

在 40 例病例中，p16 阳性的有 36 例，其中包括 35 例鳞状细胞癌（SCC）（角化型 14 例中有 14 例阳性，其中 11 例阳性；非角化型 35 例中有 21 例阳性，其中 20 例阳性），2 例腺癌（均阳性），2 例腺鳞癌（均阳性）和 1 例小细胞神经内分泌癌（阳性）。p16 阴性的有 4 例（10%）（角化型 3 例，非角化型 1 例）。HPV 非相关型和角化型 SCC 形态与 p16 无关的癌的 P 值具有显著性。当 p16 阳性与其他参数相关联时，P 值无显著性。