P16蛋白检测在预测Ⅰ级宫颈上皮内瘤变进展风险中的应用价值评价

Feasibility of P16 protein in predicting the evolvement of cervical intraepithelial neoplasiaⅠ

目的探讨P16蛋白免疫组化检测用于预测Ⅰ级宫颈上皮内瘤变(CINⅠ)病变进展风险的可行性。方法选择经组织学检查确诊的CINⅠ患者136例,以单纯随访为临床治疗方案;采用免疫组化SP法检测其相应宫颈组织中P16蛋白表达。随访期间,间隔6个月复查细胞学、阴道镜,必要时重复宫颈活检。以随访第36个月组织学检查结果为近期病变转归结局,分析P16蛋白表达作为CINⅠ病变进展预测指标的可行性。结果 CINⅠ组织中P16蛋白阳性表达率为40.44%(55/136)。随访36个月,CINⅠ病变总进展率为13.97%(19/136)。以P16蛋白表达评分大于或等于6分作为CINⅠ进展的预测指标,其灵敏度、特异度、阳性预测值及阴性预测值分别为57.89%、93.16%、57.89%、93.16%(P<0.01)。结论 P16蛋白表达强度与CINⅠ病变转归密切相关,可作为CINⅠ进展风险的预测指标之一。

Objective To discuss the feasibility of P16 immunohistochemistry examination in predicting the evolvement of cervical intraepithelial neoplasia（CIN）Ⅰ.Methods 136 patients with CINⅠ were treated by following up only.The expression of P16 was detected by immunohistochemistry at the original time.Cytology and Colposcopy were repeated every 6 months,and on the 36th months,histology were considered the sequel of CINⅠ.The feasibility of the expression of P16 in predicting the evolvement of CINⅠwere evaluated.Results The positive rate of P16 in CINⅠ were 40.44%（55/136）.There were 19 cases（13.97%,19/136） deteriorated into lesions over CINⅡ after 36 months.The sensitivity,specificity,positive predictive value and negative predictive value of the expression of P16 with grading more than 6 in predicting the deterioration of CINⅠ were 57.89%,93.16%,57.89% and 93.16% respectively（P0.01）.Conclusion The expression of P16 was of value in prognosis of CINⅠ and could be considered one of the measurements to predict deterioration of CINⅠ.