不同宫颈病变组织中HPV分型及P16、Ki-67的表达

Detection of HPV gene and the expression of P16 and Ki-67 in different cervical lesions

(1)目的讨论不同宫颈病变组织中人乳头瘤病毒(HPV)的基因分型及多肿瘤抑制基因(P16)、Ki-67的表达情况。(2)方法收集2015年7月~2016年8月因液基细胞学检测异常或HPV感染就诊于我院的患者91例均行阴道镜检查及活检,包括低级别宫颈上皮内瘤变(low-grade squamous intraepithelial lesions,LSIL)组、高级别宫颈上皮内瘤变(high-grade squamous intraepithelial lesions,HSIL)组各31例,以及宫颈鳞癌组29例;选择同期32例慢性宫颈炎患者作为对照组。采用Cobas4800技术检测高危型HPV(HR-HPV)在不同宫颈病变组织中的感染情况,采用免疫组化技术检测不同宫颈组织中P16和Ki-67的表达强度。(3)结果随着宫颈病变程度的增加,HR-HPV的感染率增高,HRHPV在不同宫颈组织中的感染率差异显著(χ2=26.67,P<0.05);入选患者中主要为单一HR-HPV感染,随着宫颈病变程度的增加,HR-HPV的多重感染率也增加,且不同宫颈病变组织间的多重感染率差异有统计学意义(χ2=15.934,P<0.05)。P16、Ki-67在不同宫颈组织中表达水平差异显著,均有统计学意义(P<0.05),且其表达水平与宫颈病变程度密切相关,随着宫颈病变程度的增加,P16、Ki-67的表达水平和染色范围逐渐增加,经过Spearman相关分析,计算结果分别为γ=0.784、γ=0.840,双侧检验水准P<0.05。(4)结论 HR-HPV的感染率及P16、Ki-67的表达强度与宫颈病变程度密切相关,P16和Ki-67有望作为诊断宫颈病变程度的重要辅助指标。

Objective To explore the HPV genotypes and the expression of P16.Ki-67 in differ- ent cervical lesions.Methods A total of 123 patients who underwent colposcopy and biopsy during July 2015 to August 2016 because of abnormal liquid based cytology or HPV （human papillomavirus） posi- tive in the our hospital were entrolled in the study.They were divided into study group and the control group.The study dgroup included 31 cases of low-grade squamous intraepithelial lesions （LSIL）,31 ea- ses of high-grade squamous intraepithelial lesion （HSIL） and 29 cases of cervical cancer.The infection of high risk HPV （HR-HPV） in different cervical lesions was detected by Cobas4800 technique meth- od, and the expression of P16 and Ki-67 underwent immunuhisto-chemistry to detect the expression of the degree of cervical lesions, analysis of the expression of SCCA, P16 and Ki-67 in cervical lesions and their relationship with the degree of cervical lesions. Results With the increased in the degree of cervical lesions, HR-HPV infection rate increased, the infection rate of HR-HPV in different cervicaltissues was significantly different （X2 = 26.67, P d0.05） ; The patients were mainly single HR-HPV in- fection rate also increased, and the difference of multiple infection rates among different cervical lesions was statistically significant （9（2= 15. 934, P %0.05）.The expression intensity of P16 and Ki-67 was closely related to the severity of cervical intraepithelial neoplasia （intraepithelial neoplasia cervical, CIN）, The expression level of P16.Ki-67 was statistically significant differences in different cervical tissues （P〈0.05）,and the expression level of the factors in the cervical tissue was closely related to the degree of cervical lesions, the correlation coefficients were r = 0.784, r = 0.840, P 〈0.05.Conclusion The infection rate of HR-HPV and the expression intensity of P16 and Ki-67 are closely related to the degree of cervical lesions.P16 and Ki-67 are expected to be the important supplementary indicators for the diagnosis of cervical lesions.