免疫组织化学技术在子宫颈上皮内病变中的应用及其临床病理学意义

Application and clinical significance of immunohistochemical technique on cervical intraepithelial neoplasia

目的:探讨子宫颈上皮内病变(CIN)组织中免疫组织化学的应用及其临床病理学意义。方法:选择256例子宫颈活检组织标本,采用免疫组织化学技术检测P16、P53、P63和Ki-67表达,其中30例正常子宫颈组织为对照组,CIN1 70例、CIN2 80例、CIN3 76例。结果:正常鳞状上皮P16、P53、P63和Ki-67免疫组化染色均为阴性或弱阳性,而在CIN中各级病变均有较高表达,且随CIN级别升高而表达增强,各组间有差别并与CIN分级呈正相关(P<0.01)。同时P16、P63二者阳性表达均见分层现象,在CIN1中细胞的阳性表达大多局限于宫颈鳞状上皮的下1/3,在CIN2中阳性细胞达皮下2/3,而CIN3中则在上皮下2/3直至全层弥漫阳性。P53和Ki-67的阳性表达从CIN1到CIN3逐渐增加,多组之间比较及CIN1与CIN2两组之间比较差别有统计学意义(P<0.01),但CIN2与CIN3两组之间的比较差异无统计学意义(P>0.05)。结论:在子宫颈病变中检测P16、P53、P63和Ki-67蛋白的表达,有助于子宫颈癌前病变的筛查、早期诊断和治疗。

Objectives：To investigate the application and clinical significance of immunohistochemical technique on cervical intraepithelial neoplasia.Methods：256 cases of cervical biopsy specimens were selected.The expression of p1 6 ,p53,p63and Ki-67 protein was detected by immunohistochemical technique.There were 30 ca-ses of normal cervical epitheliums in control group,70 cases in CIN1 group,80 cases in CIN2 group and 76 cases in CIN3 group.Results：Immunohistochemical staining of P1 6,P53,P63 and Ki-67 in normal squamous epithelium were negative or weakly positive and P1 6,P53,P63 and Ki-67 in CIN group had higher levels of expression.The level of expression went higher along with the CIN level.Expression between groups was statistically significant （P〈0.01 ）and positively correlated.Meanwhile,expression of P1 6 and P63 was in stratification.Expression of P53 and Ki-67 gradually increased from CIN1 group to CIN3 group.The differences between multiple groups and between CIN1 group and CIN2 group were statistically significant （P〈0.01 ）,but the difference between CIN2 group and CIN3 group was not statistically significant （P〉0.05）.Conclusions：The detection of expression of P1 6,P53,P63 and Ki-67 proteins in cervical lesions is helpful for the screening,early diagnosis and treatment of precancerous le-sions of cervix.