宫颈癌及癌前病变中Ki-67、P16蛋白的表达差异及诊断价值  

Expression of Ki-67,P16 in cervical cancer and precancerous lesions and their diagnostic value

作　　者：刘峰[1] 张春霞[1] 张莉[1] 于云英[1] LIU Feng;ZHANG Chun-xia;ZHANG Li;YU Yun-ying(Department of Obstetrics and Gynecology,Shengli Oil Field Central Hospital,Dongying 257000,Shandong,China)

机构地区：[1]胜利油田中心医院妇产科,东营257000

出　　处：《中国临床医学》2018年第2期278-281,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:观察宫颈癌及癌前病变组织中Ki-67、P16蛋白的表达差异,探讨二者对宫颈癌及癌前病变的鉴别诊断价值。方法:选取2014年8月至2016年8月我院收治的90例宫颈上皮内瘤变(CIN)和40例宫颈癌患者作为研究对象,采用免疫组织化学染色法检测患者活检病理组织标本中Ki-67、P16蛋白的表达,诊断试验评估Ki-67、P16蛋白表达鉴别诊断宫颈癌及癌前病变的价值。结果:宫颈癌组织Ki-67蛋白阳性表达率高于CIN,高级别CIN组织Ki-67蛋白阳性表达率高于低级别CIN,差异有统计学意义(P<0.05)。宫颈癌组织P16蛋白阳性表达率高于CIN,高级别CIN组织P16蛋白阳性表达率高于低级别CIN,差异有统计学意义(P<0.05)。P16鉴别诊断CIN与宫颈癌的敏感性高于Ki-67,差异有统计学意义(P<0.05)。Ki-67、P16蛋白联合诊断在区分CIN与宫颈癌及低级别CIN与高级别CIN的敏感性明显优于单独诊断(P<0.05)。结论:Ki-67、P16蛋白联合诊断对区分不同组织学分级癌前病变及宫颈癌具有重要的辅助诊断价值。Objective:To explore the clinical significance of Ki-67 and P16 in cervical cancer and precancerous lesion.Methods:We selected 90 cases of cervical intraepithelial neoplasia(CIN)and 40 cases of cervical cancer patients of our hospital from August 2014 to August 2016 as a clinical research object,using the immunohistochemical staining method to detect patients with pathological tissue specimens in the expression of P16 and Ki-67,comprehensive analysis of cervical cancer and precancerous lesions in the Ki-67 and compare the differences in the levels of P16 expression and its significance in clinical diagnosis.Results:Ki-67 and P16 were both expressed in cervical and precancerous lesions,the positive rate of Ki-67 in CIN was significantly lower than that in cervical cancer,but the expression of Ki-67 in CIN patients was significantly higher than that in low grade CIN patients(P<0.05).The positive expression rate of P16 in cervical cancer was significantly higher than that in CIN and low grade CIN(P<0.05).the positive expression rate of P16 in low grade CIN was significantly lower than that in CIN(P<0.05).The sensitivity of P16 in the differential diagnosis of CIN and cervical cancer was significantly higher than that of Ki-67(P<0.05).The sensitivity and specificity of P16 in the diagnosis of low grade CIN and high grade CIN were significantly lower than that of Ki-67,and there was no significant difference between groups.The sensitivity of Ki-67 and P16 joint diagnosis in distinguishing CIN and cervical cancer and low grade CIN and high grade CIN were significantly higher than that in single diagnosis(P<0.05).The specificity of differential diagnosis for CIN and cervical cancer was the same as Ki-67.Conclusions:Ki-67 and P16 have some expression in cervical cancer and precancerous lesion,and the joint diagnosis between Ki-67 and P16 is important in the diagnosis of CIN and the diagnosis of cervical cancer.

关 键 词：KI-67 P16 宫颈癌 癌前病变 

分 类 号：R711.74[医药卫生—妇产科学]