P16、Ki-67蛋白表达及HPV检测在宫颈上皮内瘤变中的意义

Significance of P16,Ki-67 protein expression and HPV detection in cervical intraepithelial neoplasia

目的探讨P16、Ki-67蛋白在宫颈上皮内瘤变(CIN)中的表达情况和意义及人乳头瘤病毒(HPV)感染与CIN的关系。方法选取2017年1月至2018年2月宿迁市钟吾医院160例行宫颈组织活检或宫颈LEEP术活检患者作为研究对象,其中40例正常宫颈黏膜上皮组织的患者作为对照组,120例出现CIN患者作为观察组,两组均检测P16、Ki-67蛋白的表达情况,同时检测HPV的感染情况。结果对照组P16、Ki-67的阳性率明显低于观察组,差异有统计学意义(P<0.05)。观察组在高度宫颈上皮内瘤变(CINⅡ和CINⅢ)患者中,P16和Ki-67的表达呈正相关(r=0.785,P<0.05),高度上皮内瘤变患者P16、Ki-67阳性率明显高于轻度宫颈上皮内瘤变(CINⅠ)患者。观察组HPV阳性率明显高于对照组,差异有统计学意义(P<0.05),HPV阳性率与P16的表达呈正相关(r=0.486,P<0.05),且HPV阳性率随CIN的发展而升高。结论联合检测P16和Ki-67可作为诊断CIN的有效指标,HPV的感染与CIN的发生有着密切联系,对临床上诊断CIN有着重要的意义。

Objective To investigate the expression and significance of P16 and Ki-67 protein in cervical intraepithelial neoplasia(CIN)and the relationship between HPV infection and CIN.Methods From January 2017 to February 2018,160 cases with cervical biopsy or cervical LEEP operation as the research object in Zhongwu Hospital of Suqian,40 cases of normal cervical mucosa epithelial tissue of patients as control group,120 cases with CIN of patients as observation group,two groups were detected the expression of P16 and Ki-67 protein,while detecting HPV infection status.Results The positive rate of P16 and Ki-67 in the control group was significantly lower than that in the observation group,the difference was statistically significant(P<0.05).In the high-grade cervical intraepithelial neoplasia(CINⅡand CINⅢ),the expression of P16 and Ki-67 was positively correlated(r=0.785,P<0.05).The positive rate of P16 and Ki-67 in highly intraepithelial neoplasia was significantly higher than that in mild cervical intraepithelial neoplasia(CINⅠ).The positive rate of HPV in the observation group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).The positive rate of HPV was positively correlated with the expression of P16(r=0.486,P<0.05),and the positive rate of HPV increased with the development of CIN.Conclusion Combined detection of P16 and Ki-67 can be used as an effective indicator for the diagnosis of CIN.HPV infection is closely related to the occurrence of CIN,and has important significance for clinical diagnosis of CIN.