Ki67免疫组织化学定量分析在宫颈鳞状上皮内瘤变病理分级中的应用

Cervical Intraepithelial Neoplasia Grading by Ki67 Immunoquantitation

目的用Ki67免疫组织化学定量测定评估宫颈鳞状上皮内瘤变(CIN)病理分级。方法 190例经2位病理医师按WHO(2003)宫颈癌前病变标准诊断为不同级别CIN的宫颈切片,经Ki67免疫组织化学染色后,用医学图像分析系统定量测定宫颈上皮Ki67分层指数(stratification index,SI)、鳞状上皮各层的标记指数(label index,LI)及每100μm基底膜阳性细胞核数等3个参数。结果在190例宫颈活检病例中,病理学诊断96例CIN1,72例CIN2,22例CIN3。上述3个参数在不同级别CIN之间差异均有统计学意义(均P<0.05)。单纯用Ki67 SI评估CIN级别,与病理分级一致率为54.3%;而将各组Ki67 SI与中层LI结合评估,与病理分级一致率可达76.8%。结论宫颈鳞状上皮Ki67 SI和中层LI结合评估有助于提高CIN分级的准确性。

Objective To determine cervical intraepithelial neoplasia （CIN）grading by Ki67 immunoquantitative analysis. Methods 190 cervical slides diagnosed as different CIN grades（96 cases of CIN1,72 cases of CIN2 and 22 cases of CIN3） were stained by Ki67 immunohistochemistry. Medical imaging analysis system was used to quantitatively measure Ki67 stratification index（SI）in cervical epithelia,label index（LI）in each layer of squamous epithelia and number of positive nuclei per 100 /,m basal membrane. Results There were significant differences in Ki67 SI,I.I and number of positive nuclei per 100/,m basal membrane among different CIN grades（P〈0. 05）. 54.3 % overall classification with Ki67 SI and 76.8 % correct classification with combined Ki67 SI and I.I in the middle third layer epithelium were respectively found in the consensus grades. Conclusion Ki67 immunoquantitative analysis of SI combined with LI can be used to distinguish different CIN grades.