P16和C-fos、C-jun在外阴癌变中的表达及临床意义
The expression and clinical significance of P16 andC-fos、C-jun in vulvar Neoplasia
摘要
目的：探讨抑癌基因P16和原癌基因C-fos、C-jun在外阴癌变中的表达及临床意义。方法：选取1995-2005年经手术切除及活检存档的蜡块，常规HE染色确认的VSCC30例、VIN40例（I-II和III各20例）、NNED标本40例、正常外阴皮肤10例；用免疫组织化学（S-P法）检测C-fos、C-jun和P16的表达，并计算阳性细胞指数（LI）。结果：C-fos、C-jun在正常外阴皮肤、VNNED和VIN I-II中无表达，VIN III中的阳性率分别为13.6%和18.5%；VSCC中的阳性率分别为30.2%和40.6%；VSCC与VIN III均有显著性差异（P<0.05）；P16蛋白在正常外阴皮肤的表达为100%；VNNED、VIN I-II、VIN III和VSCC中的阳性率分别为87.5%（35/40）、85%（17/20）、75%（15/20）和40%（12/30）；VSCC与VNNED、VIN均有显著性差异（P<0.05）；C-fos、C-jun 在VIN III中的细胞阳性指数分别为33.6%和35.4%；VSCC中的阳性指数分别为90.2%和88.8%；VSCC与VIN III均有显著性差异（P<0.05）；P16蛋白在正常外阴皮肤、VNNED、VINI-II、VIN III和VSCC中的细胞阳性指数分别为97.5%、73.65%、66.27%、63.34%和11.9%，VSCC组与其他各组间比较均有显著性差异（P<0.05）。结论：C-fos、C-jun、P16联合检测，无论组织学表达，还是细胞阳性指数，对VSCC、VIN和NNED具有明显的鉴别意义。Abstract
Objective: To evaluate the expression and clinical significance of tumor suppressor gene P16 and proto-oncogene C-fos、C-jun in vulvar neoplasia. Methods: Archived wax blocks which were got by resection and biopsy between 1995 and 2005 are selected. By conventional HE staining, we confirm that there are Vulvar squamous cell carcinoma (VSCC) (n=30), Vular intraepithelial neoplasia (VIN) (n=40) (I-II 20 and III 20), non- neoplasia epithelial disorders(NNED) (n=40) and normal genital skin (n=10). Then Immunohistochemistry (SP method) is used to detected C-fos, C-jun and P16 expression. The index of positive cells (LI) is also calculated. Results: C-fos, C-jun are of absent expression in normal genital skin, VNNED and VIN I-II while their positive rates are 13.6% and 18.5% in VIN III，30.2% and 40.6% in VSCC, simultaneously,VSCC and VIN III are significantly different (P <0.05). P16 protein is expressed in all the normal vulvar skin while its positive rates are 87.5% (35/40), 85% (17/20), 75% (15/20) and 40% (12/30) in VNNED、VIN I-II、VIN III and VSCC, furthermore there are significant differences between VSCC、VNNED and VIN (P <0.05). The positive indexs of C-fos, C-jun in the cells of the VIN III are 33.6% and 35.4%, at the meanwhile, in VSCC, they are 90.2% and 88.8%, VSCC and VIN III are significantly different (P <0.05).The positive indexs of P16 protein in cells of normal genital skin, VNNED, VINI-II, VIN III and VSCC are 97.5%, 73.65%, 66.27%, 63.34% and 11.9%.Comparing VSCC with any other group, we find there are significantly different (P <0.05).Conclusions: Whether the expression of tissue cytology or the positive index of cells, jointing detection of C-fos, C-jun and P16 is obviously significant in respect to differential diagnosis of VSCC、VIN and NNED. 
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