P16、Ki-67在宫颈上皮内瘤样变中的表达及其意义

Clinical and Pathological Analysis of P16 and Ki-67 in Cervical Intraepithelial Neoplasia

[目的]探讨P16、Ki-67蛋白在宫颈上皮内瘤样变（CIN）组织中的表达及其意义。[方法]收集本院2013年1月至2016年1月收治的96例疑诊为CIN的患者宫颈活检标本，依据宫颈活检结果将患者分为CINⅠ组22例、CINⅡ组26例、CINⅢ组28例与良性病变良性病变组20例。比较各组P16、Ki-67蛋白表达情况。[结果]各组p16、Ki-67阳性检出率比较差异有统计学意义（P〈0．05），CINⅡ和CINⅢ组p16、Ki-67阳性检出率均显著高于CINⅠ组（P〈0．05），良性病变组阳性检出率显著低于其他三组（P〈0．05）；各组p16和Ki-67阳性表达率比较差异具有统计学意义（P〈0．05），CINⅡ和CINⅢ组阳性检出率均高于CINⅠ组（P〈0．05），CINⅢ组阳性检出率均高于CINⅡ组（P〈0．05），良性病变组无阳性表达；CINⅠ组、CINⅡ和CINⅢ组高危型HPV-DNA的阳性表达率分别为31．82％（7／22）、65．38％（17／26）、85．71％（24／28），各组HPV-DNA的阳性表达率比较差异具有统计学意义（χ^2=15．464，P=0．000）。[结论]P16、Ki 67蛋白表达与CIN进展及分级密切相关，提示P16、Ki-67蛋白可作为宫颈病变较可靠的指标。

[Objective]To investigate the clinical significance of Ki-67 and P16 protein expression in the diagnosis of cervical intraepithelial neoplasia. [Methods]Ninety-six patients with cervical intraepithelial neoplasia （CIN） were selected from our hospital from January 2013 to January 9,016. Cervical biopsy specimens of all the patients were collected. According to the results of cervical biopsy, the patients were divided into a CINⅠ group with22 cases, a CINⅡ group with 26 cases, a CIN group with 28 cases and 20 cases of benign lesions. The expressions of P16 and Ki-67 protein in each group were analyzed and compared. [Results]The difference in positive rates of P16 and Ki-67 were statistically significant （ P〈0.05） ; in the CIN Ⅱ and CIN Ⅲ groups the positive rates of P16 and Ki-67 were higher than that of CIN Ⅰ group （ P %0.05）, while the positive rate of the benign group was significantly lower than those of the other three groups （ P 〈0.05）. The positive rates of the CIN Ⅱ and Ⅲ groups were higher than that of the CIN Ⅰ group （ P 〈0.05） ; the positive rate of CIN Ⅲ group was higher than that of CIN Ⅱ group （ P 〈0.05）. No positive expression was detected in the benign lesion group. The positive expressions of high-risk HPV-DNA in CINⅠ , Ⅱ and Ⅲ groups were 31.82% （7/ 22）, 65.38% （17/26） and 85.71% （24/28）, respectively, and the differences among each group were statistically significant （X2= 15.464, P =0.000）. [Conclusion]The expression of Ki-67 and P16 protein is closely related to the progression of cervical intraepithelial neoplasia; the combined detection of Ki-67 and P16 can be used as an important method for the diagnosis of cervical intraepithelial neoplasia.