p16和Ki-67在低级别鳞状上皮内病变预测持续性高危型HPV感染中的应用价值

Value of p16 and Ki-67 protein in prediction of persistent infection of high risk human papillomavirus with low-grade squamous intraepithelial neoplasia

目的探讨p16和Ki-67在持续性感染高危型人乳头状瘤病毒(hr HPV)的低级别鳞状上皮内病变(LSIL)中的预测价值。方法搜集174例宫颈活检诊断为LSIL的病例,对这些病例行免疫组化p16和Ki-67染色。并分别于活检时、活检后6个月及12个月做hr HPV分型检测。结果 174例LSIL中30例持续性感染hr HPV,86例一过性感染hr HPV,58例未检测到hr HPV。其p16的阳性率分别为60%、61.6%和55.2%,Ki-67的阳性率分别为53.3%、52.3%和55.2%。p16和Ki-67的阳性率在持续性hr HPV感染的LSIL组、一过性hr HPV感染组及未检测到hr HPV组间差异不显著(P>0.05)。结论不同的hr HPV感染状态p16和Ki-67的表达无明显差异,推断p16和Ki-67不能预测持续性hr HPV感染。因为病例有限,尚需扩大样本量以进一步确定。

Objective To investigate the predictive value of p16 and Ki-67 protein in low-grade squamous intraepithelial neoplasia （LSIL） infected with persistent high risk human papillomavirus （hrHPV）. Methods 174 cases of cervical biopsy specimens with LSIL were collected, and biopsy specimens were detected by p16 and Ki-67 immunostaining. Furthermore, 174 women with LSIL were recruited into 12-month follow-up, and type-specific hrHPV detection was used at baseline and at 6-month-interval. Results 174 patients with LSIL included 30 cases with persistent infection of hrHPV, 86 with transient infection and 58 with uninfection of hrHPV. The positive rate of p16 in persistent hrHPV infection, transient infection and uninfeetion was 60%, 61.6% and 55.2%, respectively, and the positive rate of Ki-67 was 53.3%, 52. 3% and 55.2%, respectively. There was no significant difference of p16 and Ki-67 expression among persistent hrHPV infection, transient infection and uninfection （p16, X^2= 0. 607, P 〉 0. 05; Ki-67, X^2= 0. 113, P 〉 0. 05）. Conclusion Positive rate of p16 and Ki-67 is not correlated with status of hrHPV infection, p16 and Ki-67 cannot predict persistent hrHPV infection. Since the number of cases is limited, and therefore a further study of larger-size samples is needed to verify those findings.