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目的 为了探明抑癌基因 p16在子宫平滑肌瘤发生发展中的作用及其在诊断中的临床意义。方法 应用细胞免疫荧光技术及流式细胞术 ,对 5 5例子宫平滑肌肿瘤石蜡组织块的 p16表达定量分析。结果 正常子宫平滑肌组织 p16表达均为阴性。14例平滑肌瘤仅 2例出现过度表达 (14 % ) ;交界性平滑肌肿瘤 12例 ,多数为过度表达 (75 % ) ;子宫平滑肌肉瘤 2 9例中 ,则有 2 7例 (93% )出现过度表达。从平滑肌瘤、交界性平滑肌瘤到平滑肌肉瘤 ,p16表达量显著递增。p16表达量随肿瘤细胞分裂相、异型性、密度的增高也有明显增高。p16低表达者5 a生存率为 85 % ,而过度表达者为 4 8%。结论 子宫平滑肌肿瘤一旦出现 p16过度表达应考虑为恶性 ;p16表达可能和平滑肌瘤向平滑肌肉瘤的转化密切相关 ,p16表达可作为判断病人预后的一项客观指标。
Objective To explore the role of tumor suppressor gene p16 in the development of uterine leiomyoma and its clinical significance in the diagnosis. Methods Quantitative analysis of p16 expression in paraffin sections of 5 5 uterine smooth muscle tumors was performed by immunofluorescence and flow cytometry. Results The normal uterine smooth muscle tissue p16 expression were negative. In 14 cases of leiomyoma only two cases were over-expressed (14%); borderline smooth muscle tumors in 12 cases, the majority of overexpression (75%); 29 cases of uterine leiomyosarcoma in 29 cases (93%) appeared Overexpression. From leiomyoma, borderline leiomyoma to leiomyosarcoma, p16 expression increased significantly. The expression of p16 with the tumor cell division, atypia, increased density also significantly increased. The 5-year survival rate was 85% for p16 low expression and 48% overexpression. Conclusion The overexpression of p16 in uterine smooth muscle tumors should be considered as malignant. The expression of p16 may be closely related to the leiomyoma to leiomyosarcoma transformation. The expression of p16 may be used as an objective index to judge the prognosis of patients.