p16和Ki-67在宫颈鳞癌癌前病变中的表达及其诊断价值

Study on the expression and diagnostic value of P16 and Ki-67 in cervical squamous cell carcinoma and precancerous lesions

目的探讨抑制基因蛋白(p16)和增殖细胞核蛋白(Ki-67)在宫颈鳞状上皮内瘤变(CIN)和宫颈鳞癌表达和诊断中的应用价值。方法采用免疫组化SP法检测18例正常宫颈黏膜上皮、58例宫颈鳞状上皮内瘤变及17例宫颈鳞癌组织中p16和Ki-67表达水平。结果 p16和Ki-67阳性表达率从子宫颈正常组到CIN I、CIN II、CINⅢ组、子宫颈鳞癌组逐渐上升,各CIN组和宫颈鳞癌组与子宫颈正常组比较均有显著性差异(P均<0.05),p16和Ki-67两项指标在CINⅠ、Ⅱ、Ⅲ组及子宫颈鳞癌组中表达呈正相关性(P均<0.05),p16和Ki-67联用对于区分正常子宫颈和低级别CIN以及区分低级别CIN和高级别CIN较p16和Ki-67单用敏感性比较有显著差异(P均<0.05),特异性比较无显著性差异(P均>0.05)。结论 p16和Ki-67检测对CIN和宫颈鳞癌表达和诊断具有重要价值。

Objective It is to observe the expression of suppressor gene protein （p16） and proliferating cell nuclear pro- teins （Ki -67 ） in cervical squamous intraepithelial neoplasia （CIN） and cervical carcinoma, and approach the diagnostic val- ue of them. Methods The expressions of p16 and Ki -67 were detected by Immunohistocbemical SP method in 18 cases of nor- mal cervical epithelium, 58 cases of cervical squamous intraepithelial neoplasia and 17 cases of cervical squamous cell carcino- ma. Results The positive expression rate of p16 and Ki - 67 were gradually increased from normal group to CIN Ⅰ , CIN Ⅱ , CIN Ⅲ group and cervical squamous cell carcinoma group, There were significant difference between the normal group and others （all P 〈 0.05）. p16 and Ki -67 in CIN Ⅰ , Ⅱ , Ⅲ group and cervical squamous cell carcinoma group was positively correlated with the expression （P 〈 0.05）. There were significant difference in sensitivity of p16 and Ki -67 to distinguish normal cervix and low-lebel CIN, or low-grade CIN and high - grade CIN （ P 〈 0.05 ） , but was no significant difference in specificity （ P 〉 0.05 ）. Conclusion The detection of p16 and Ki - 67 has important valuable to diagnose CIN and cervical car- cinoma.