Ki-67、环氧合酶-2和高危型人乳头瘤病毒在宫颈病变中的表达及其与疾病进程的相关性  

Expression and clinical significance of Ki-67,cyclooxygenase-2 and high-risk human papilloma virus in cervical lesions

作　　者：张春霞[1] 刘峰[1] 连丽峰[2] 于云英[1] ZHANG Chunxia; LIU Feng; LIAN Lifeng;YU Yunying(Department of Gynaecology, Shengli Oilfield Central Hospital, Dongying 257000, Shandong, China)

机构地区：[1]胜利油田中心医院妇科,山东东营257000 [2]胜利油田中心医院检验科,山东东营257000

出　　处：《上海医学》2018年第9期519-523,共5页Shanghai Medical Journal

摘　　要：目的检测Ki-67、环氧合酶(COX)-2和高危型人乳头瘤病毒(HPV)在宫颈病变中的表达,并分析其与宫颈上皮内瘤变(CIN)进程的相关性。方法选择胜利油田中心医院自2014年8月—2016年8月收治的80例宫颈癌患者(其中Ⅰ至Ⅱa期50例、Ⅱb至Ⅲ期30例)和90例CIN患者(其中Ⅰ级44例、Ⅱ级20例、Ⅲ级26例)。采用免疫组织化学染色法检测患者病理组织标本中Ki-67和COX-2的表达,同时采用第二代捕获杂交法检测患者HPV感染情况。采用Pearson相关性分析研究Ki-67、COX-2和高危型HPV表达水平与CIN进程的相关性。结果 Ki-67在宫颈癌Ⅰ至Ⅱa期(χ~2=0.200)和Ⅱb至Ⅲ期(χ~2=0.149)中的阳性表达率均显著高于在不同CIN分级中的阳性表达率(P值均<0.05),且其阳性表达率随CIN分级的增加而升高(F=34.043,P<0.05);COX-2在宫颈癌Ⅰ至Ⅱa期(χ~2=0.222)和Ⅱb至Ⅲ期(χ~2=0.167)中的阳性表达率均显著高于在不同CIN分级中的阳性表达率(P值均<0.05),且其阳性表达率随CIN分级的增加而升高(F=31.035,P<0.05)。Pearson相关性分析结果显示,宫颈组织中Ki-67水平(r=0.375 2)和COX-2水平(r=0.243 7)均与CIN分级呈正相关(P值均<0.05)。HPV16/18在CINⅠ至Ⅲ级和宫颈癌Ⅰ至Ⅲ期组织阳性样本相对光单位(RLU)/阳性对照RLU的比值均≥1.0,提示HPV16/18为高危型HPV。CINⅠ级病变中HPV6/11阳性率显著高于CINⅡ级(χ~2=0.666)和CINⅢ级(χ~2=0.702)、宫颈癌Ⅰ至Ⅱa期(χ~2=0.230)和宫颈癌Ⅱb至Ⅲ期(χ~2=0.192,P值均<0.05);宫颈癌Ⅰ至Ⅱa期(χ~2=0.166)和Ⅱb至Ⅲ期(χ~2=0.354)中HPV16/18的阳性率均显著高于不同分级CIN中HPV16/18的阳性率(P值均<0.05),且HPV16/18阳性率随CIN分级的增加而升高(F=29.072,P<0.05)。Pearson相关性分析结果显示,HPV16/18的阳性率与CIN分级呈正相关(r=0.433 8,P<0.05)。结论宫颈病变组织中的Ki-67、COX-2和高危型HPV的表达水平均与宫颈病变的进程密切相关,将其用于宫颈癌的靶向防治具有�Objective To explore the expression of Ki-67 and cyclooxygenase-2 （COX-2） in cervical lesions, to analyze its correlation with high-risk human papilloma virus （HPV） infection and their clinical significance in cervical intraepithelial neoplasia （CIN）. Methods Eighty patients with cervical cancer （50 in stage Ⅰ - Ⅱ a and 30 in stage Ⅱ b- Ⅲ ） and ninety patients with CIN （44 in grade Ⅰ , 20 in grade Ⅱ and 26 in grade Ⅲ ） admitted to our hospital from August 2014 to August 2016 were chosen in this study, The expressions of Ki-67 and COX-2 in pathological tissue samples were detected by immunohistochemical staining. High-risk HPV infection was measured by the hybrid capture-][ （HC-Ⅱ） method. Pearson correlation analysis was used to analyze the correlation between the levels of Ki-67 and COX-2 and CIN progression and the correlation between high-risk HPV and CIN progression. Results The expressions of Ki-67 and COX-2 in patients with cervical cancer stage Ⅰ - Ⅱ a （X2 = 0. 200, X2 = 0. 222） and stage Ⅱ b- Ⅲ （X2 = 0. 149, X2 = 0. 167） were significantly higher than those in patients with different CIN grades （all P〈0.05）. The expressions of Ki-67 and COX-2 increased with the increase of CIN grade （F = 34. 043, F = 31. 035, both P〈0.05）. Pearson correlation analysis showed that the levels of Ki-67 （ r = 0. 375 2） and COX-2 （ r = 0. 243 7） were significantly positively correlated with the increase of CIN grade （both P〈0.05）. The mean relative light unit （RLU） in HPV16/18 positive samples of CIN Ⅰ - Ⅲ and cervical cancer tissues was significantly higher than that of HPVS/11 positive samples, suggesting that HPV16/18 may be a high-risk HPV. The positive rate of HPV6/11 in CIN grade I lesions was significantly higher than those in ClN Ⅱ （X2 = 0. 666）, CIN m （x2 = 0. 702）, cervical cancer stage Ⅰ - Ⅱ a （x2 = o. 230） and cervical cancer stage Ⅱb-Ⅲ （X2 = 0. 192, all P〈O. 05）. The positive rates of HPV16/18 in ce

关 键 词：KI-67抗原 环氧化酶2 宫颈病变 高危型人乳头瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]