p16、Ki-67在宫颈鳞状上皮病变分级诊断中的意义  

The significance of p16 and Ki-67 testing in grading diagnosis of cervical squamous intraepithelial lesions

作　　者：赫芳芳 高英[2] 魏力[1] 

机构地区：[1]中国医科大学附属第四医院妇科,辽宁沈阳110000 [2]中国医科大学附属第四医院病理科,辽宁沈阳110000

出　　处：《现代肿瘤医学》2016年第8期1271-1274,共4页Journal of Modern Oncology

基　　金：沈阳市科学技术计划项目(编号:F10-149-9-37)

摘　　要：目的:探讨p16、Ki-67联合应用在宫颈鳞状上皮病变分级诊断中的意义。方法:采用免疫组化方法检测117例宫颈各类病变活检组织中p16、Ki-67蛋白表达情况,并对该组患者液基薄层细胞学(TCT)、高危型人乳头瘤病毒基因检测(HPV-DNA)结果进行比较。结果:根据HE组织学形态,结合免疫组化染色结果修订原有诊断,其中LSIL、HSIL的构成比差异有统计学意义。p16在LSIL、HSIL中的阳性表达率分别为0.00%、97.30%,Ki-67则分别为21.57%、67.58%(P<0.05)。TCT和HPV-DNA检测HSIL的敏感度89.19%,特异度39.61%。联合应用p16、Ki-67的敏感度46.67%,特异度95.74%。结论:联合免疫组化染色检测p16、Ki-67可作为宫颈鳞状上皮病变分级诊断的重要标记物。联合TCT、HPV-DNA在宫颈癌筛查中有较高的敏感度,但特异度有限,需与p16、Ki-67免疫组化染色相结合。Objective： To investigate the significance of p16 and Ki-67 testing in grading diagnosis of cervical squamous intraepithelial lesions. Methods： One hundred and seventeen cervical biopsy specimens were collected from different grades of cervical intraepithelial lesions. The expressions of p16 and Ki-67 were evaluated by immunohisto chemical staining. Cervical smears were tested for Thinprep cytology test and high-risk human papilloma virus. Results： The differences were statistically significant between the constituent ratios of low-grade squamous intraepithelial lesions（ LSIL） and high-grade squamous intraepithelial lesions（ HSIL）（ P〈0. 05）. The positive expression rates of p1 6 in LSIL and HSIL were 9 7. 3 0 % and 0. 00%,respectively（ P〈0. 05）. Ki-67 rates were 67. 58%and 21. 57%（ P〈0. 05）. The sensitivity and specificity of combination of TCT and HPV-DNA were 89. 19%,39. 61%,respectively. While the sensitivity and specificity of p16,Ki-67 staining were 46. 67%,95. 74%,respectively. Conclusion： It plays a significant role in distinguishing LSILs from HSILs in which cervical biopsy specimens were tested by p16 and Ki-67 immunohistochemical stain. The positive expression rates of p16 and Ki-67 were correlated with the severity of cervical disease. The combination of TCT and HPV-DNA has a high sensitivity but with a low specificity in screening for cervical carcinoma. p16 and Ki-67 immunohistochemical staining should be tested.

关 键 词：宫颈鳞状上皮病变 P16 KI-67 免疫组织化学染色 HPV-DNA TCT 

分 类 号：R730.4[医药卫生—肿瘤] R737.33[医药卫生—临床医学]