年轻女性宫颈CINⅠ/Ⅱ级病变中p16^(InK4a)和Ki67临床意义  

Expression of p16^(InK4a) and Ki67 and their significance in predicting progression of cervical intraepithelial neoplasia Ⅰ~Ⅱ in young women

作　　者：李思琦[1] 董颖[2] 毕蕙[1] 张晓明[2] 陈锐[1] 

机构地区：[1]北京大学第一医院妇产科,北京100034 [2]北京大学第一医院病理科,北京100034

出　　处：《中国性科学》2014年第5期41-44,共4页Chinese Journal of Human Sexuality

摘　　要：目的:探讨年轻女性宫颈CINI/II级病变组织p16InK4a及Ki67在预测病变转归中的作用与意义。方法:选取2010年在北大医院妇产科门诊就诊、年龄小于35岁、经阴道镜活检病理诊断为CINⅠ及CINⅡ级的病例56例,对其阴道活检组织之石蜡切片,进行p16InK4a及Ki67免疫组织化学染色。并对病例进行随访。结果:(1)阴道镜活检组织的CINI及CINII中p16InK4a阳性表达率分别为30.0%、80.6%,Ki67阳性率分别为20.0%、77.8%;(2)在高危HPV持续感染病例组的p16InK4a及Ki67阳性率低于未持续感染病例组,差异有统计学意义(p16InK4a:25.0%和69.0%,P=0.041;Ki67:12.5%和64.3%,P=0.015);(3)活检组织p16InK4a及Ki67的阳性率在随访一年CIN进展/未进展组中未见显著差异(p16InK4a:P=0.106;Ki67:P=0.173)。结论:p16InK4a及Ki67对CIN进展及HR-HPV持续感染的预测提示作用有待进一步研究证实。Objectives： This study aims to detect the expression of p16^InK4aand ki67 in CIN I ～ Ⅱ in young women,and to evaluate their value in predicting progression and HR- HPV（ high risk human papilloma virus） persistence. Methods： Fifty- six women（ ≤35 y） with a histological diagnosis of CINI ～ Ⅱ,who attended a colposcopy with cone biopsy in Peking University First Hospital Obstetrics and Gynecology Out- patient Department in 2010,were included in this study. P16^InK4aand ki67 immunohistochemical staining were performed on all tissues. Follow- up was conducted. Results： i. In punch biopsy tissues： expression rate of p16^INK4a in CINI and CINII were 30. 0% and 80. 6% respectively,with a significant difference（ P〈0. 001）; expression rate of Ki67 in CINI and CINⅡ were 20. 0% and 77. 8% respectively,with a significant difference（ P 〈0. 001）. ii. The expression rate of both p16^INK4a and ki67 in punch biopsy tissues was lower in group with HR- HPV persistence than the other group.（ p16^InK4a： 25. 0% vs 69. 0%,P =0. 041; Ki67： 12. 5% vs 64. 3%,P = 0. 015）. iii. The expression rate of both p16InK4aand ki67 in punch biopsy tissues showed non- significant correlation with progression of CIN（ p16^InK4a： P =0. 106; Ki67： P =0. 173）. Conclusion： The potential role of p16INK4aand Ki67 in the prediction of CIN progression and HR- HPV persistence should be further discussed.

关 键 词：P16INK4A KI67 年轻女性 宫颈上皮内瘤变 

分 类 号：R711.74[医药卫生—妇产科学]