Stathmin-1、p53、Ki-67蛋白联合检测在食管鳞状上皮内瘤变分级诊断及预测术后复发中的应用价值  

Application value of combined detection of Stathmin-1,p53,and Ki-67 proteins in grading diagnosis of esophageal squamous intraepithelial neoplasia and prediction of postoperative recurrence

作　　者：王康[1] 王春[2] 周文倩 叶梓楠 杨春[2] WANG Kang;WANG Chun;ZHOU Wen-qian;YE Zi-nan;YANG Chun(Nanjing Hospital of Traditional Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing 210000,China;Nanjing Tongren Hospital Affiliated to Southeast University,Nanjing 210000,China)

机构地区：[1]南京中医药大学附属南京中医院,南京210000 [2]东南大学附属南京同仁医院,南京210000

出　　处：《诊断病理学杂志》2025年第3期244-250,共7页Chinese Journal of Diagnostic Pathology

基　　金：南京市卫生科技发展专项资金项目计划(编号:YKK22261)。

摘　　要：目的探讨Stathmin-1、p53、Ki-67蛋白联合检测在食管鳞状上皮内瘤变分级诊断中的应用价值,及其对术后复发的预测价值。方法回顾性纳入80例食管鳞状上皮内瘤变患者包括56例食管高级别鳞状上皮内瘤变组(EHGSIN组)、24例食管低级别鳞状上皮内瘤变组(ELGSIN组)、20例正常食管黏膜组织(正常组)和80例食管鳞状细胞癌患者癌组织,食管鳞状细胞癌组织切片标本进行Stathmin-1免疫组化染色,其余切片标本均进行p53、Ki-67和Stathmin-1免疫组化染色。术后6个月进行复查,根据复发情况分为复发组23例与非复发组57例。以病理结果为金标准,分析p53、Ki-67两者联合检测和Stathmin-1、p53、Ki-67联合检测对食管鳞状上皮内瘤变分级的诊断效能及对术后复发的预测效能。结果食管鳞状上皮内瘤变组Stathmin-1阳性表达率均高于正常组(P<0.01),且均低于食管鳞状细胞癌组(P<0.01)。EHGSIN组中p53、Ki-67和Stathmin-1阳性表达率均高于ELGSIN组(P<0.05)。p53和Ki-67阳性的食管鳞状上皮内瘤变组织中Stathmin-1阳性表达率高于p53和Ki-67阴性食管鳞状上皮内瘤变组织(P<0.05)。p53、Ki-67和Stathmin-1联合检查诊断分级的灵敏度、特异度、曲线下面积(AUC)高于p53、Ki-67两者联合检查。p53、Ki-67和Stathmin-1联合检查预测术后复发的灵敏度、特异度、AUC均高于p53、Ki-67两者联合检查。结论Stathmin-1、p53、Ki-67蛋白联合检测对于食管鳞状上皮内瘤变分级、术后复发具有一定诊断和预测价值,有助于提高食管鳞状上皮内瘤变的诊断准确率,为临床相关诊治方案的制订提供参考信息。Objective To explore the application value of combined detection of Stathmin-1,p53,and Ki-67 proteins in grading diagnosis of esophageal squamous intraepithelial neoplasia(ESIN)and their predictive value for postoperative recurrence.Methods A retrospective analysis was conducted on 80 patients with esophageal squamous intraepithelial neoplasia,including 56 patients in the esophageal high-grade squamous intraepithelial neoplasia(EHGSIN)group,24 patients in the esophageal low-grade squamous intraepithelial neoplasia(ELGSIN)group,20 patients with normal esophageal mucosa as the control group,and 80 patients with esophageal squamous cell carcinoma.Tissue sections in esophageal squamous cell carcinoma group were stained immunohistochemically for Stathmin-1,and the other sections were stained immunohistochemically for p53,Ki-67,and Stathmin-1.Six months after the surgery,the patients were divided into recurrent group(23 cases)and non-recurrent group(57 cases).With pathological results as the gold standard,the diagnostic accuracy of combined detection of p53 and Ki-67 versus combined detection of Stathmin-1,p53,and Ki-67 for grading esophageal squamous intraepithelial neoplasia and predicting postoperative recurrence was analyzed.Results The positive rate of Stathmin-1 expression in esophageal squamous intraepithelial neoplasia group was higher than that in normal group(P<0.01),and lower than that in esophageal squamous cell carcinoma group(P<0.01).The positive expression rates of p53,Ki-67,and Stathmin-1 in the EHGSIN group were higher than those in the ELGSIN group(P<0.05).When comparing esophageal squamous intraepithelial neoplasia tissues with positive p53 and Ki-67 to those with negative p53 and Ki-67,the positive expression rate of Stathmin-1 was greater(P<0.05).The sensitivity,specificity,and area under the curve(AUC)of the combined detection of p53,Ki-67,and Stathmin-1 for grading diagnosis were higher than those of the combined detection of p53 and Ki-67.Similarly,the sensitivity,specificity,and AUC of the comb

关 键 词：Stathmin-1 P53 Ki-67 食管鳞状上皮内瘤变 分级诊断 术后复发 

分 类 号：R739.9[医药卫生—肿瘤]