联合p16、Ki-67免疫组织化学染色在宫颈上皮内瘤变分级诊断中的应用效果观察

Effects of combined immunohistochemical staining of P16 and Ki-67 on the grading diagnosis of cervical intraepithelial neoplasia

[目的]探究与分析联合应用p16、Ki-67免疫组织化学染色对宫颈上皮内瘤变(CIN)分级诊断的影响.[方法]回顾性分析自2019年3月至2021年11月间收治的接受宫颈液基薄层细胞学检查(TCT)且检查结果异常的60例患者的临床资料.全部患者按照苏木精-伊红染色法(HE)结果分为慢性宫颈炎组(n=19)、CINⅠ组(n=15)、CINⅡ组(n=12)、CINⅢ组(n=10)、宫颈癌组(n=4),全部患者均进行了宫颈阴道镜活检、人乳头瘤病毒(HPV)分型检测,并配合采用P16、Ki-67免疫组织化学染色的半定量评分,以判断患者宫颈病变程度.[结果]随着宫颈CIN病变程度的升高,CINⅢ组分别与CINⅠ组、CINⅡ组相比,CINⅡ组与CINⅠ组相比,P16表达阳性程度及Ki-67表达阳性程度升高,差异有统计学意义(P<0.05).慢性宫颈炎组P16、Ki-67免疫组织化学结合半定量评分与HE染色CIN分级诊断结果相符,CINⅠ组、CINⅡ组、CINⅢ组诊断结果相符率为94.59%,差异具有统计学意义(P<0.05).P16呈阳性表达时与HPV感染呈正相关(P<0.05).HPV-16、HPV-18、HPV-35、HPV-39、HPV-51在P16表达阳性与阴性方面差异具有统计学意义(P<0.05).[结论]CIN分级与P16、Ki-67的表达呈正相关,且P16与患者HPV感染有密切的关系.

OBJECTVE To explore and analyze the effect of combined immunohistochemical staining of p16 and Ki-67 on the grading diagnosis of cervical intraepithelial neoplasia(CIN).METHODS The clinical data of 60 patients with abnormal results of cervical liquid-based thin layer cytology(TCT)admitted to our hospital from March 2019 to November 2021 were retrospectively analyzed.All patients were divided into chronic cervicitis group(n=19),CINⅠgroup(n=15),CINⅡgroup(n=12),CINⅢgroup(n=10)and cervical cancer group(n=4),all patients underwent cervical colposcopy biopsy,human papillomavirus(HPV)typing,and semi-quantitative immunohistochemical staining with P16 and Ki-67.score to judge the degree of cervical lesions in patients.RESULTS With the increase of the degree of cervical CIN lesions,the positive degree of P16 expression and Ki-67 expression were higher,and the difference was statistically significant(P<0.05).In the chronic cervicitis group,P16 and Ki-67 immunohistochemistry combined with semi-quantitative scores were completely consistent with the CIN grading results of HE staining.The consistent rate of CINⅠ,CINⅡand CINⅢgroups was 94.59%,and the difference was statistically significant(P<0.05).Positive expression of P16 was positively correlated with HPV infection(P<0.05).HPV-16,HPV-18,HPV-35,HPV-39 and HPV-51 showed significant differences in the positive and invisible expression of P16(P<0.05).CONCLUSIONS The CIN grade of cervical intraepithelial neoplasia has a significant positive correlation with the expression of P16 and Ki-67,and P16 is closely related to HPV infection in patients.