P16、Ki-67在HPV相关宫颈上皮内瘤变中的表达及意义

Expression and significance of P16 and Ki-67 in HPV associated cervical intraepithelial neoplasia

目的检测P16、Ki-67在宫颈上皮内瘤变(CIN)中的表达及高危型人乳头状病毒(HR-HPV)DNA,探讨其在临床病理诊断中的意义。方法采用免疫组化的方法检测100例CIN 1级、100例CIN 2级、100例CIN 3级样本中P16、Ki-67的表达,采用HC-2法检测HPV DNA。结果 P16、Ki-67阳性染色定位于细胞质、胞核,HPV DNA≥1.0 pg/ml为阳性;其中宫颈低级别上皮内瘤变阳性率为57%、87%、62%,宫颈高级别上皮内瘤变阳性率为90.5%、98%、78.5%,差异有统计学意义(P<0.01);对照组阳性率为7%、31.5%、10%,与宫颈低级别上皮内瘤变组和宫颈高级别上皮内瘤变组相比,差异有统计学意义(P<0.01)。结论宫颈上皮内瘤变中P16、Ki-67的高表达,再结合HR-HPV DNA,可以作为辅助诊断CIN的指标,并能有效区分宫颈高级别上皮内瘤变与宫颈低级别上皮内瘤变。

[ Objective ] To detect the expression of P16, Ki-67and HR-HPV DNA in cervical intraepithefial neoplasia （CIN）, and investigate their significance in the pathological diagnosis. [Methods] P16 and Ki-67 expression was detected in 100 cases of CIN1, 100 cases of CIN2,100 cases of CIN3 via immunohistochemistry. HR-HPV DNA was detected by HC-2. [Results ] P 1 6, Ki- 67 positive staining was localized in the cytoplasm,nucleus （HPV DNA≥1.0 pg/ml as the positive ）.The positive rates of the low- grade CIN were 57%, 87%, 62%, respectively, that of the high-grade CIN were 90.5%,98%, 78.5%, respectively, with significant differences （P〈0.01）. The positive rates of control group were 7%,31.5%, 10%, respectively,compared with low-grade CIN and high-grade CIN ,the differences were significant （P〈0.01）. [Conclusion] The high expression of Ki-67 and P16 in CIN ,combined with HR-HPV detection,can be used as a index of auxiliary diagnostic CIN,and can distinguish between low-grade CIN and high-grade C1N effectively.