HER-2/neu和p16在外阴上皮内非瘤变中的表达及其意义

目的针对外阴上皮内非瘤变(nonneoplastic epithelial disorders of vulva,NNEDV)难治疗易复发的特点,应用免疫组化方法检测外阴白色病变组织中人表皮生长因子受体-2(human epidermal growth factor receptor 2,HER-2)/neu和p16蛋白表达水平的变化,并探讨其与外阴白色病变发生、发展的关系,以了解外阴白色病变的发病和治疗机制。方法选择煤炭总医院妇产科2014年5月至2016年1月NNEDV组织36份为研究组,其中硬化性苔癣(lichen sclerosus,LS)10例,鳞状上皮细胞增生(squamous hyperplasia,SH)18例,SH合并LS 8例;另选择阴道前后壁修补术者标本12份为正常对照组。应用免疫组化方法检测HER-2/neu和p16蛋白质的表达,并分析其与NNEDV发病的关系。结果发现p16表达率在正常外阴皮肤为25%,高于外阴白色病变患者的11.1%,差异无统计学意义(P0.05)。LS和SH组织中p16蛋白阳性表达率分别为10%和5.6%,差异无统计学意义(P0.05)。正常外阴皮肤组织HER-2/neu蛋白表达率为8.3%,外阴白色病变患者为55.5%,明显高于正常外阴者(P0.05)。LS和SH组织中,HER-2/neu蛋白阳性表达率分别为40%和66.7%,两者比较差异有统计学意义(P0.05)。结论原癌基因HER-2/neu和抑癌基因p16是调控细胞增殖周期进程的重要因子,其突变或缺失可能导致蛋白异常表达。它们参与了外阴异常增殖过程,在NNEDV甚至外阴上皮内瘤变及外阴鳞癌的发生、发展过程中起重要作用。

Expression of HER-2/neu and p16 protein in nonneoplastic epithelial disorders of vulva

Objective To investigate the relationship between human epidermal grouth factor receptor 2(HER-2)/neu and p16 protein and the expression of nonneoplastic epithelial disorders of vulva ( NNEDV) .In order to understand the pathogenesis and to seek effective treatments .Methods Biopsies from 36 cases with NNEDV including 10 cases with lichen sclerosus ( LS) ,18 with squamous hyperplasia ( SH) and 8 SH complicated with LS in China Meitan General Hospital from May 2014 to January 2016 were choosen as research group .They were examined for protein expression of HER -2/neu and p16 using immunohistochemical techniques .Normal vulvar tissues from 12 patients with other benign gynecologic diseases were used as control .Results Immunopositive expression of p 16 protein in the research group was 11.1%,with no significant difference from the control group (P>0.05);the respective positive rate of p16 in LS and SH were 10%and 5.6%with no significant difference;55.5%percent of patients with NNEDV were immunopositive for HER-2/neu,which was significantly higher than that of control group 8.3%( P<0.05);there was significant difference between LS (40%) and SH patients(66.7%,P<0.05) in the expression of HER -2/neu protein.Conclusion Proto oncogene HER -2/neu and tumor suppressor gene p 16 protein are important factors in regulating cell cycle progression .Their inactivation may play an important role in the genesis and development of NNEDV , vulvar intraepithelial neoplasia ( VIN) and vulvar squamous cell carcinoma (VSCC).