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目的:探讨hr-HPV(16/18)DNA及4种免疫标记物(p16,Vimentin,ER,PR)表达组型的检测在宫颈腺癌(ECA)和子宫内膜腺癌(EMA)鉴别诊断中的价值。方法:分别采用原位杂交和免疫组化(EliVisionTMplus)法对ECA和EMA肿瘤组织中的hr-HPV(16/18)DNA和4种免疫标记物(p16,Vimentin,ER,PR)的表达进行检测。阳性表达细胞≤50%为低表达(L),>50%为高表达(H)。结果:1hr-HPV(16/18)DNA在ECA和EMA中的检出率分别为72.7%(24/33)和12.9%(4/31)。ECA中hr-HPV(16/18)DNA检出率显著高于EMA(P<0.01)。2在24例hr-HPV(16/18)DNA阳性的ECA病例中4种标记物组合有2种表达组型。其中23例(95.8%)呈p16(H)/Vim(L)/ER(L)/PR(L)表达类型,在9例hr-HPV(16/18)DNA阴性的ECA病例中,8例呈p16(L)/Vim(L)/ER(L)/PR(L)表达组型(88.9%)。3在27例hr-HPV(16/18)DNA阴性的EMA病例中,4种标记物组合有5种表达组型。其中21例(77.8%)为p16(L)/Vim(H)/ER(H)或/和PR(H)表达组型。在4例hr-HPV(16/18)DNA阳性EMA病例中,2例呈p16(H)/Vim(H)/ER(L)/PR(L)表达组型(50.0%),剩余2例(50.0%)分别为p16(H)/Vim(L)/ER(L)/PR(L)和p16(H)/Vim(H)/ER(H)/PR(H)表达组型。结论:hr-HPV(16/18)DNA检测和4种免疫标记物组合(p16,Vimentin,ER,PR)的不同表达组型在ECA和EMA的鉴别诊断中具有重要实用价值。
Objective: To investigate the differential diagnosis of cervical adenocarcinoma (ECA) and endometrial adenocarcinoma (EMA) using hr-HPV (16/18) DNA and four kinds of immunohistochemical markers (p16, Vimentin, ER, PR) In the value. Methods: The expression of hr-HPV (16/18) DNA and 4 kinds of immune markers (p16, Vimentin, ER, PR) in ECA and EMA tumor tissues were respectively performed by in situ hybridization and immunohistochemistry Detection. Positive cells ≤ 50% of low expression (L),> 50% of high expression (H). Results: The detection rates of 1hr-HPV (16/18) DNA in ECA and EMA were 72.7% (24/33) and 12.9% (4/31), respectively. The detection rate of hr-HPV (16/18) DNA in ECA was significantly higher than that in EMA (P <0.01). 2 There are two expression patterns for the four markers in 24 hr-HPV (16/18) DNA-positive ECA cases. Among the 9 HPV-negative (16/18) DNA-negative ECA cases, 23 (95.8%) showed p16 (H) / Vim (L) / ER (L) / PR The expression pattern was p16 (L) / Vim (L) / ER (L) / PR (L) (88.9%). 3 In 27 cases of hr-HPV (16/18) DNA-negative EMA cases, the four markers combined had five expression patterns. Among them 21 (77.8%) were p16 (L) / Vim (H) / ER (H) or / and PR (H) expression. Two cases of p16 (H) / Vim (H) / ER (L) / PR (L) expression group (50.0%) were found in 4 cases of hr-HPV DNA positive EMA cases (50.0%) were p16 (H) / Vim (L) / ER (L) / PR (L) and p16 (H) / Vim (H) / ER (H) / PR (H) CONCLUSION: The different expression patterns of hr-HPV (16/18) DNA and four immunological marker combinations (p16, Vimentin, ER, PR) are of great practical value in the differential diagnosis of ECA and EMA.