子宫颈癌及癌前病变HPV16、Ki-67的表达及其相关性

Correlation of HPV16 infection with Ki-67 expression in cervical cancer and its precursor lesions

目的对子宫颈癌及癌前病变中HPV感染和增殖细胞核抗原Ki-67表达情况进行研究。方法对45例子宫颈浸润性鳞状细胞癌、5例子宫颈腺癌、35例子宫颈上皮内瘤变(CIN)和5例正常宫颈组织采用免疫组化EnVision法进行HPV16和Ki-67表达的检测。结果HPV16阳性率为78.9%(71/90),其中HPV16阳性率在子宫颈癌组织中为76.0%(38/50),在CIN病变中为94.3%(33/35),在正常子宫颈黏膜上皮组织中为阴性(0/5)。Ki-67阳性细胞在正常子宫颈、CIN和子宫颈癌组织中表达逐级增加,显示Ki-67表达程度与组织学类型有关。HPV和Ki-67在CIN和癌组织中的表达呈显著相关(P<0.005)。结论瑞安地区子宫颈癌及癌前病变组织中存在HPV感染,HPV感染可能在子宫颈癌的发生、发展中起着重要作用。联合应用Ki-67与HPV可作为筛选子宫颈癌高危个体有价值的生物学标记。

Purpose To study human papilloma virus （HPV） infection and expression of Ki-67 antigen in cervical cancer and its precursor lesions. Methods The expression of HPV16 and Ki-67 was detected by immunohistochemical staining in 5 cases of normal cervical tissue, 35 cases of cervical intraepithelial neoplasia and 50 cases of cervical carcinoma. Results The positive rates of HPV16 in carcinoma and CIN were 76. 0% （38/50） and 94. 3% （33/35）, respectively. HPV infection was not detected in normal cervical mucosa. The positive rates of HPV16 in CIN and cervical carcinoma were significantly higher than those in normal cervical mucosa （P 〈 0. 005）. The positive rates of Ki-67 in CIN and cervical carcinoma were 97.1% （34/35） and 94. 0% （47/50）, respectively. Ki-67 indices were significantly elevated as CIN grade increasing. A positive correlation was found between the Ki-67 expression and the pathological grading of the lesions （ P 〈 0. 05 ）. Conclusions There is HPV16 infection in the cases of cervical carcinoma and its precursor lesion in Ruian area. HPV16 infection may play an important role in carcinogenesis of cervical carcinoma. There is a positive correlation between the abnormal expression of HPV16 and Ki-67 in cervical carcinoma and its precursor lesions. It is suggested that Ki-67 and HPV16 expression may be taken as an effective biomarkers for cervical carcinoma and its precancerous lesions.