p16、Ki-67和P53在高级别宫颈鳞状上皮内病变精准诊断中的价值  

The value of p16、Ki-67and P53in accurate diagnosis of high-grade cervical intraepithelial lesion

作　　者：王慧香[1] 徐孟宇 余晖 许涛 李岳 WANG Hui-xiang;XU Meng-yu;YU Hui(Department of Obstetrics and Gynecology,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院妇产科,北京100730

出　　处：《中国实验诊断学》2021年第7期977-980,共4页Chinese Journal of Laboratory Diagnosis

基　　金：首都医科大学本科生科研创新项目(NO.XSKY2019192)。

摘　　要：目的测定不同级别宫颈鳞状上皮内病变(SIL)中p16、Ki-67、P53蛋白的表达水平,探讨联合检测上述生物学标记物对HSIL的辅助诊断价值。方法回顾性分析2015年3月-2018年3月首都医科大学附属北京同仁医院阴道镜活检病理标本共180例,根据病理组织学诊断结果分为HSIL组、LSIL组及宫颈炎组,每组各60例,其中宫颈炎组作为对照组。采用免疫组化SP法检测p16、Ki-67、P53表达情况,判断检测方法的灵敏度、特异度,评价联合检测的诊断效能。结果p16在HSIL组、LSIL组及宫颈炎组的阳性率分别为95.00%、73.33%、15.00%;Ki-67阳性表达率分别为86.67%、65.00%、8.33%;P53阳性表达率分别为96.67%、80.00%、8.33%。p16、Ki-67和P53阳性表达率随宫颈病变级别的升高而呈上升趋势,三组比较差异有统计学意义(P<0.01);p16、Ki-67和P53三种生物学指标联合应用并联灵敏度95.6%,特异度85.5%;三者串联灵敏度81.6%,特异度100%。结论p16、Ki-67和P53在一定程度上可以客观反映SIL严重程度,联合应用可有效筛选HSIL,提高HSIL诊断准确率,为精准分流SIL病人提供依据,指导个体化治疗。Objective Explore the expression of p16、Ki-67and P53in different cervical squamous intraepithelial lesion,to evaluate the value of biological markers in improving the diagnosis of high-grade cervical intraepithelial lesion.Methods A total of 180cervical samples,which selected from Beijing Tongren Hospital Affiliated to Capital Medical University from March 2015to March 2018.According to the result of pathological diagnosis by routine HE staining,these samples were divided into three groups,including HSIL,LSIL and cervicitis.Every group 60cases.The expression of p16、Ki-67and P53in cervical tissue of all patients were detected by immunohistochemistry.And the sensitivity,specificity and the value of different diagnosing method were analyzed.Results In HSIL,LSIL and cervicitis group,the positive expression rates of p16were 95.00%、73.33%、15.00%,the positive rates of Ki-67were 86.67%、65.00%、8.33%,the positive rates of P53were 96.67%、80.00%、8.33%.The positive expressions rates of p16、Ki-67and P53 were increased with the grade of cervical lesions(P<0.01).The sensitivity and specificity of p16、Ki-67、P53parallel connection were 95.6%and 85.5%,respectively.The sensitivity and specificity of p16、Ki-67、P53series connection were 81.6%and 100%,respectively.Conclusion The semi-quantitative score of p16、Ki-67and P53immunohistochemistry staining can reflect the degree of cervical lesions.These biological indicators has certain guiding significance effective for enhancing the accuracy of HSIL diagnosis in clinical practice.

关 键 词：宫颈鳞状上皮内病变 P16 KI-67 P53 免疫组化 

分 类 号：R737.33[医药卫生—肿瘤]