BAG-1及p16在宫颈上皮内瘤变中的诊断价值

Diagnostic value of BAG-1 and p16 in cervical intraepithelial neoplasia

目的:检测宫颈上皮内瘤变(CIN)组织中BAG-1及p16蛋白的表达,探讨其在CIN中的诊断价值。方法:采用免疫组化法检测正常宫颈组织及CIN组织中BAG-1及p16的表达情况,其中正常宫颈/慢性宫颈炎30例、CIN1及CIN2/3各60例。结果:BAG-1及p16表达率在正常/慢性宫颈炎组为3.3%(1/30)及0,CIN1组为36.7%(22/60)及28.3%(17/60)、CIN2/3组为90%(54/60)及86.7%(52/60),二者的表达均随着病变严重程度的上升而增高(χ^2=50.875及103.560,P<0.01),且CIN2/3组与CIN1组相比,BAG-1及p16的表达率均明显升高(χ^2=46.538及51.361,P<0.01)。BAG-1及P16诊断区分CIN1及CIN2/3的灵敏度分别为90.0%及86.7%,特异度分别为63.3%及71.7%,BAG-1的阴性预测值(NPV)(86.4%)比p16(84.3%)略高,而阳性预测值(PPV)(71.1%)比p16(75.4%)略低。结论:BAG-1对诊断不同级别CIN具有较高的灵敏度及特异度,BAG-1可能作为一种新的生物分子标志物与p16联合检测用以辅助诊断CIN1及CIN2/3。

Objective:To detect the expression of BAG-1 and p16 protein in cervical intraepithelial neoplasia(CIN),and to explore its diagnostic value in CIN. Methods: Immunohistochemistry was used to detect the expression of BAG-1 and p16 in normal cervical tissues and CIN tissues,including 30 cases of normal cervix/chronic cervicitis,60 cases of CIN1 and 60 cases of CIN2/3. Results:The expression rates of BAG-1 and p16 were 3.3%(1/30)and 0 in the normal/chronic cervicitis group,and 36.7%(22/60)and 28.3%(17/60)in the CIN1 group,the CIN2/3 group was 90%(54/60)and 86.7%(52/60),both of the expression rates increased with the severity of the lesion(χ^2=50.875 and 103.560,P<0.01),and the expression rates of BAG-1 and p16 were significantly higher in CIN2/3 group than in CIN1 group(χ^2=46.538 and 51.361,P<0.01).The sensitivity of BAG-1 and p16 for differentiating between CIN1 and CIN2/3 were 90.0% and 86.7%,respectively,the specificity was 63.3% and 71.7%,respectively. The negative predictive value(NPV)of BAG-1(86.4%)was slightly higher than that of p16(84.3%),while the positive predictive value(PPV)(71.1%) was slightly lower than that of p16(75.4%). Conclusion:BAG-1 has high sensitivity and good specificity for differentiating different levels of CIN. BAG-1 may be used as a new biomolecular marker combined with p16 to assist the diagnosis of CIN1 and CIN2/3.