Objective To detect the expression and significance of p16,HPV,CK20 in pelvic lymph node micrometastases in postoperative uterine cervix cancer.Methods Using the Envision immunohistochemical method to study the expression of pelvic lymph node paraffin section in p16,HPV,CK20 samples,with the group 1(transfer after pelvic lymph node operation with routine pathological examination),group 2(without transfer after pelvic lymph node operation testing with pathological examination,but fellow-up happened)and the comparison group(neither transfer after pelvic lymph node operation and other complications testing with pathological examination,nor fellow-up period).Compare the results with two methods that the immunohistochemical method and serial sectioning.Results The expression of p16 in the group was 100％,and the expression was 1.25％ in the group 2,and there was not expression in the comparison group.For the HPV and CK20 there was not expression among the three groups.In the group 2 it was found lymph gland at one patient during the serial sectioning indicating the pelvic lymph node micrometastases which 3 of 5 sections had the positive results with p16,but the comparison group had not found.In the group 1 there was 4 paraffin sections with no transfer during serial sections.Conclusion p16 may be the label for micrometasrases to evaluate the early uterine cervix cancer and there were the clinical significance.But the significance of HPV and CK20 need further study in the cervix cancer.The increasing diagnostic rate of uterine cervix cancer was due to combine the serial sections testing.%目的 探讨p16、HPV、CK20在宫颈癌术后盆腔淋巴结微转移中的表达及意义.方法 运用Envision免疫组织化学法对研究组1(术后常规病理检查盆腔淋巴结有转移)、研究组2(术后常规病理检查盆腔淋巴结无转移,但随访期限内有复发)及对照组(术后常规病理检查无盆腔淋巴结转移及其他高危因素,随访期限内无复发)的盆腔淋巴结石蜡切片组织进行p16、HPV、CK20表达的检测;采用连续切片法与免疫组化检测结果进行对比.结果 p16在研究组1中表达率为100％,在研究组2中表达率1.25％(1/80),在对照组中未见表达.HPV及CK20在三组中均未见表达.研究组2中连续切片发现有1例患者1枚淋巴结(5张切片,其中3张)p16表达阳性.在常规病理切片盆腔淋巴结有转移的研究组1中,行连续切片却发现有4张蜡片无转移病灶.结论 p16可作为宫颈癌微转移标记物,对于评价早期宫颈癌微转移具有临床意义,HPV及CK20在宫颈癌微转移中的意义尚需进一步研究.
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