宫颈组织中增殖细胞抗原和微血管密度的表达及相关性分析  

Expression and correlation analysis of proliferating cell antigen and microvessel density in cervical tissue

作　　者：陈燕[1] 袁马驰 赵霞[1] CHEN Yan;YUAN Ma-chi;ZHAO Xia(Department of Obstetrics and Gynecology,Hangzhou Third People's Hospital,Hangzhou,Zhejiang 310009,China;不详)

机构地区：[1]杭州市第三人民医院妇产科,浙江杭州310009 [2]杭州市第三人民医院病理科

出　　处：《中国妇幼保健》2023年第21期4241-4246,共6页Maternal and Child Health Care of China

基　　金：浙江省杭州市科技发展计划项目(20191203B112)。

摘　　要：目的研究增殖细胞抗原(PCNA)和微血管密度(MVD)在宫颈组织中的表达特点,探讨二者联合应用的诊断价值。方法选取2018年12月—2020年12月在杭州市第三人民医院行宫颈液基薄层细胞学检查和高危型人乳头瘤病毒(HPV)检测的患者为研究对象,根据国际癌症协会对宫颈/阴道细胞学的诊断标准,对宫颈液基薄层细胞学筛查异常或筛查正常且HPV16或18阳性的患者行阴道镜下宫颈组织活检,经病理诊断证实为宫颈上皮内瘤变(CIN)行宫颈环形电切除术或宫颈冷刀锥切术的患者63例为观察组,其中CINⅠ级28例,CINⅡ/Ⅲ级35例,另选取同期在该院因子宫肌瘤行子宫切除术,同时病理诊断为正常宫颈组织的患者25例作为对照组。对所有患者的石蜡标本进行观察,取病变最严重区域行PCNA和MVD免疫组化染色。结果对照组PCNA的阳性表达率为64.00%;CINⅠ级组PCNA的阳性表达率为96.43%;CINⅡ/Ⅲ级组中PCNA的阳性表达率为100.00%。对照组PCNA阳性过表达率为4.00%,CINⅠ级组PCNA阳性过表达率为32.14%,CINⅡ/Ⅲ级组PCNA阳性过表达率为91.43%。对照组与CINⅠ级组、对照组与CINⅡ/Ⅲ级组PCNA阳性表达率比较,差异均有统计学意义(χ^(2)=18.15、23.60,均P<0.05);CINⅠ级组与CINⅡ/Ⅲ级组PCNA阳性表达率比较,差异无统计学意义(χ^(2)=0.01,P>0.05);但CINⅡ/Ⅲ级组与CINⅠ级组PCNA阳性过表达率比较,差异有统计学意义(χ^(2)=22.97,P<0.05)。MVD在对照组、CINⅠ级组及CINⅡ/Ⅲ级组中的表达水平分别为(12.92±4.01)、(21.36±6.14)及(29.79±5.68);CINⅠ级组与CINⅡ/Ⅲ级组MVD表达均明显高于对照组,差异均有统计学意义(t=5.883、12.727,均P<0.05);CINⅡ/Ⅲ级组MVD表达明显高于CINⅠ级组,差异有统计学意义(t=5.645,P<0.05);MVD表达随宫颈病变级别升高而呈增加趋势。Pearson相关性分析显示,PCNA阳性表达与MVD值呈正相关关系(r=0.595,P<0.05)。受试者工作特征(ROC)曲线显示,应用Objective To study the expression characteristics of proliferating cell antigen(PCNA) and microvessel density(MVD) in cervical tissues,and to explore the diagnostic value of their combined application.Methods Patients who underwent cervical liquid-based thin-layer cytology and high-risk human papillomavirus(HPV) detection in Hangzhou Third People's Hospital from December 2018 to December 2020 were selected as the research objects.According to the diagnostic criteria of cervical/vaginal cytology by the International Cancer Association,patients with abnormal or normal cervical liquid-based thin-layer cytology screening and positive HPV16 or 18 were performed colposcopy cervical biopsy.Sixty-three patients with cervical intraepithelial neoplasia(CIN) confirmed by pathological diagnosis who underwent loop electrosurgical excision procedure or cold knife conization were the observation group,including 28 patients with CINⅠ grade and 35 patients with CINⅡ/Ⅲ grade.In addition,25 patients who underwent hysterectomy for hysteromyoma and were diagnosed as normal cervical tissue by pathology were selected as the control group.Paraffin specimens of all patients were observed,and PCNA and MVD immunohistochemical staining were performed in the most serious lesion area.Results The positive expression rate of PCNA in the control group was 64.00%.The positive expression rate of PCNA in CINⅠ grade group was 96.43%.The positive expression rate of PCNA in CINⅡ/Ⅲ grade group was 100.00% respectively.The positive overexpression rate of PCNA was 4.00% in control group,32.14% in CINⅠ grade group and 91.43% in CINⅡ/Ⅲ grade group.The positive expression rate of PCNA in the control group was significantly different from that in the CINⅠ group and between the control group and the CINⅡ/Ⅲ group(χ~2=18.15,23.60,all P<0.05).There was no significant difference in the positive expression rate of PCNA between CINⅠgrade group and CINⅡ/Ⅲ grade group(χ~2=0.01,P<0.05).However,there was a significant difference in the p

关 键 词：宫颈上皮内瘤变 增殖细胞抗原 微血管密度 免疫组织化学法 

分 类 号：R711.74[医药卫生—妇产科学]