宫颈鳞状上皮内病变不同分级患者EGFR、p16蛋白、Ki67抗原表达水平及其临床意义

Expression Levels of EGFR, p16 Protein and Ki67 Antigen in Patients with Different Grades of Cervical Squamous Intraepithelial Lesions and Their Clinical Significance

目的研究宫颈鳞状上皮内病变不同分级患者EGFR、p16蛋白及Ki67抗原表达水平及其临床意义。方法于2016年1月—2019年12月选择免疫组化SP法对宫颈鳞状上皮化生患者、高级别宫颈鳞状上皮病变患者(HSIL)、低级别宫颈鳞状上皮病变患者(LSIL)各80例的标本中表皮生长因子受体(EGFR)、Ki67抗原和p16蛋白进行标记、定位与计算,对其在不同病理类型宫颈组织之间的表达及相关性进行分析。结果鳞状上皮化生患者EGFR、Ki67、p16阳性率为16.25%、12.50%、13.75%;LSIL患者阳性率分别为31.25%、78.75%、76.25%;HSIL患者阳性率分别为73.75%、96.25%、97.50%,各级患者阳性表达差异有统计学意义(χ^(2)=67.916、233.060、227.757,P<0.001)。LSIL中EGFR、Ki67、p16的阳性细胞分布于上皮下1/3层例数达72例、73例及76例,HSIL仅为4例、6例、5例,两组分布情况比较差异有统计学意义(χ^(2)=115.890、112.243、126.045,P<0.001);LSIL与HSIL中EGFR、Ki67抗原和p61蛋白相关分析,均呈正相关(r=0.38、0.40、0.43,P<0.05)。结论免疫组化SP法对ECFR、Ki67抗原和p16蛋白进行标记能够作为SIL分级的依据,临床中结合LSIL与HSIL的分布特征,可提高诊断分级的准确性。

Objective To study the expression levels of EGFR,p16 protein and Ki67 antigen in patients with different grades of cervical squamous intraepithelial lesions and their clinical significance.Methods The immunohistochemical SP method was selected to detect epidermal growth factor receptors in 80 specimens of patients with cervical squamous metaplasia,high-grade cervical squamous epithelial disease(HSIL),and low-grade cervical squamous epithelial disease(LSIL)from Janaury 2016 to December 2019.The epidermal growth factor receptor(EGFR),Ki67 antigen and p16 protein in each 80 specimens were labeled,located and calculated,and their expression and correlation between different pathological types of cervical tissues were analyzed.Results The positive rates of EGFR,Ki67,and p16 in patients with squamous metaplasia were 16.25%,12.50%,and 13.75%;the positive rates of LSIL patients were 31.25%,78.75%,and 76.25%;the positive rates of HSIL patients were 73.75%,96.25%,97.50%,and there were statistically significant differences in the positive expression of patients at all levels(χ^(2)=67.916,233.060,227.757,P<0.001).The positive cells of EGFR,Ki67,and p16 in LSIL were distributed in the subepithelial layer in 72 cases,73 cases,and 76 cases,while HSIL was only 4 cases,6 cases,and 5 cases.There was a statistically significant difference in the distribution of the two groups(χ^(2)=115.890,112.243,126.045,P<0.001);the correlation analysis of EGFR,Ki67 antigen and p61 protein in LSIL and HSIL showed a positive correlation(r=0.38,0.40,0.43,P<0.05).Conclusion The immunohistochemical SP method to label ECFR,Ki67 antigen and p16 protein can be used as the basis for SIL classification.Combining the distribution characteristics of LSIL and HSIL in clinical practice can improve the accuracy of diagnosis and classification.