Bcl-2、P16及ki-67在宫颈原位腺癌中的诊断价值

Diagnostic value of Bcl-2,P16 and ki-67 in adenocarcinomas in situ of the cervical

目的探讨Bcl-2、P16及ki-67在宫颈原位腺癌(AIS)病理诊断中的价值。方法收集AIS(A组)、宫颈腺癌(B组)及正常宫颈组织(C组)各30例患者的宫颈组织石蜡切片,用S-P免疫组化法检测抗体P16、ki-67及Bcl-2在各组中表达情况,并根据统计结果了解三种抗体联合检测AIS的特异性和灵敏度。结果 P16与Ki-67在A和B组的表达较C组均显著升高(p<0.05)。Bcl-2在C组中表达较A,B两组显著升高,比较有差异性(p<0.05)。单一抗体检测中P16、Ki-67和Bcl-2在AIS中诊断的灵敏度分别为90.00%、50.00%和13.33%,特异度分别是62.07%、72.97%和52.63%。联合检测中当发现P16和Ki-67表达均为阳性时,在诊断AIS中灵敏度和特异度分别为36.67%,58.14%。当P16阳性、Ki-67阴性时诊断AIS灵敏度和特异度分别为11.23%,37.92%,只有加用Bcl-2检测时,灵敏度和特异性增致63.33%,69.44%,高于P16和Ki-67表达均为阳性组,差异有统计学意义(p<0.05)。结论 AIS的临床诊断往往无特异性,病理诊断需做免疫组化;当免疫组化提示P16阳性、Ki-67阴性时,需增加Bcl-2检查可提高AIS的诊断特异性和敏感性。

Objective To investigate the P16, ki67 and Bcl-2 value in cervical adenocarcinoma in situ pathological diagnosis. Methods Thirty patients of cervical paraffin sections were collected from cervical adenocarcinoma （group A）, cervical adenocarcinoma （group B） and normal cervical tissue （group C）. The antibody P16, ki67 and Bcl were detected by SP immunohistochemistry2 to express the situation, and based on statistical results to understand the three antibodies combined detection of cervical in situ adenocarcinoma specificity and sensitivity. Results P16 with Ki-67 expression in group A and group B increased compared that in group C （P〈0.05）. Bcl-2 of group A and group B were significantly higher than that of group C （P〈0.05）. The sensitivity of P16, Ki-67 and Bcl-2 in diagnosis of cervical adenocarcinoma was 90%, 50% and 13.33%, respectively, and the specificity was 62.07%, 72.97% and 52.63%, respectively. The sensitivity and specificity of diagnosis of cervical adenocarcinoma were 11.23% and 37.92%, respectively. The sensitivity （63.33%） and specificity （69.44%） of positive P16 and Ki-67 were higher than those of negative P16 and B16 Ki-67 （P〈0.05）. Conclusion The clinical diagnosis of cervical adenocarcinoma is often nonspecific. The pathological diagnosis needs immunohistochemistry. When immunohistochemistry suggests that positive P16 and negative Ki-67, Bcl-2 can improve the cervical adenocarcinoma diagnostic specificity and sensitivity.