免疫组织化学技术在子宫颈上皮内病变中的应用价值分析

Application Value of Immunohistochemical Technique in Cervical Intraepithelial Lesions

目的:分析免疫组织化学技术在子宫颈上皮内病变中的应用价值。方法:收集泉州市妇幼保健院·儿童医院2019年2月-2020年10月宫颈活检或LEEP刀锥切标本163例,以子宫颈上皮内病变133例为观察组,其中低级别鳞状上皮内病变(low squamous intraepithelial lesions,LSIL)45例、高级别鳞状上皮内病变(high squamous intraepithelial lesions,HSIL)88例,以子宫肌瘤全切子宫标本的正常宫颈30例为对照组。对163例标本的p16、p63、p53、Ki-67水平使用免疫组织化学技术进行测验分析。结果:对照组p16、p63、p53、Ki-67免疫组化染色结果均为阴性。p16在HSIL组中62.50%呈中阳性表达,LSIL中75.56%呈弱阳性,差异有统计学意义(P<0.05);p53在对照组染色结果全部呈阴性(-);LSIL、HSIL组84.44%、61.36%呈中阳性(++);三组染色结果比较,差异有统计学意义(P<0.05)。p63在对照组中全部呈阴性表达,在LSIL中82.22%呈阴性,三组p63染色结果比较,差异有统计学意义(P<0.05)。Ki-67在对照组的免疫组化染色结果为阴性(-);在LSIL组中77.78%呈弱阳性(+),HSIL组中80.68%呈中阳性(++);三组染色结果阴性(-)、弱阳性(+)、中阳性(++)的表达,差异有统计学意义(P<0.05);三组染色结果强阳性(+++)表达,差异无统计学意义(P>0.05)。p16、p53、p63、Ki-67在对照组中的阳性率均为0,p16、p63、Ki-67在HSIL组中的中阳、强阳性率均高于LSIL组(P<0.05);三组p53阳性率比较,差异无统计学意义(P>0.05)。结论:免疫组织化学技术可以很好地检测子宫颈上皮内病变的具体情况,对于病变的发生和发展具有监测观察意义,有临床应用价值。

Objective:To analyze the value of immunohistochemistry technique in cervical intraepithelial lesions.Method:A total of 163 cervical biopsy or LEEP knife conization specimens in Quanzhou Maternal and Child Health Hospital·Children’s Hospital were collected from February 2019 to October 2020,133 cases of cervical intraepithelial lesions were taken as the observation group,including 45 cases of low squamous intraepithelial lesions(LSIL),88 cases of high squamous intraepithelial lesions(HSIL),and 30 cases of normal cervix of total hysterectomy of hysteromyoma as the control group.The levels of p16,p63,p53 and Ki-67 in 163 specimens were tested and analyzed by immunohistochemical technique.Result:The immunohistochemical staining results of p16,p63,p53 and Ki-67 in the control group were negative.p16 was moderately positive in 62.50%of HSIL group and weakly positive in 75.56%of LSIL group(P<0.05).p53 staining result in the control group was all negative(-);84.44%and 61.36%of LSIL and HSIL groups were moderately positive(++).There was significant difference in the staining results of the three groups(P<0.05).p63 was all negative in the control group and 82.22%negative in LSIL.There was significant difference in the staining results of p63 among the three groups(P<0.05).The immunohistochemical staining result of Ki-67 in the control group was negative(-).In LSIL group,77.78%were weakly positive(+),and in HSIL group,80.68%were moderately positive(++).There was significant difference in the expression of negative(-),weak positive(+)and medium positive(+)in the three groups(P<0.05).The staining results of the three groups were strongly positive(+++)with no significant difference(P>0.05).The positive rates of p16,p53,p63 and Ki-67 in the control group were 0,and the medium,strongly positive rates of p16,p63 and Ki-67 in the HSIL group were higher than those in the LSIL group(P<0.05).There was no significant difference in the positive rate of p53 among the three groups(P>0.05).Conclusion:Immunohistochemical technique can well detect the specific situation of cervical intraepithelial lesions.It has monitoring and observation significance for the occurrence and development of lesions and has clinical application value.