分析p16、p53及Ki-67在宫颈癌患者中的表达及联合检测的诊断价值

To analyze the expression of p16,p53 and Ki-67 in patients with cervical cancer and the diagnostic value of combined detection

目的探讨p16、p53及Ki-67在宫颈癌患者中的表达意义及三项指标联合检测的诊断效能。方法选取2019年6月至2022年10月在桂林医学院附属医院就医并确诊为宫颈癌的140例患者纳入宫颈癌组,另选取60例经本院确诊的高级别鳞状上皮病变患者纳入宫颈上皮内病变组,均为CIN2。收集本研究纳入患者的病理组织标本并检测p16、p53及Ki-67阳性表达情况,明确p16、p53及Ki-67与宫颈癌患者病理特征的关系,分析p16、p53及Ki-67三项指标联合检测对宫颈癌的诊断价值。结果宫颈癌组病理组织标本中p16、p53及Ki-67阳性表达率均明显高于宫颈上皮内病变组(均P<0.05);宫颈癌组中不同年龄患者的p16、p53及Ki-67阳性表达对比差异均无统计学意义(P>0.05),不同FIGO分期及淋巴结转移患者p16、p53及Ki-67阳性表达明显升高(均P<0.05);p16、p53、Ki-67三项联合的诊断效能包括灵敏度、特异度、阳性预测值、阴性预测值均明显高于单一指标的检测效能。结论宫颈癌组织中p16、p53、Ki-67蛋白的阳性表达与宫颈癌患者病情的发展程度、淋巴结转移相关,三项指标联合检测对筛查和明确宫颈癌患者的病变组织进展具有重要意义,亦可提高临床的诊断价值,改善患者预后。

Objective To investigate the significance of p16,p53,and Ki-67 expression in patients with cervical cancer and assess the diagnostic efficacy of their combined detection.Methods One hundred and forty patients who attended the Affiliated Hospital of Guilin Medical College from June 2019 to October 2022 and were diagnosed with cervical adenocarcinoma were included in the cervical cancer group,and another 60 patients with high-grade squamous intraepithelial lesion(HSIL) were included in the cervical intraepithelial lesion group,all of which were CIN2.The pathological tissue specimens of patients included in this study were collected and the positive expressions of p16,p53and Ki-67 were detected to clarify the relationship between p16,p53 and Ki-67 and the pathological characteristics of patients with cervical cancer,and the diagnostic value of combined detection of p16,p53 and Ki-67 in cervical cancer was analyzed.Results The positive expression rates of p16,p53 and Ki-67 in cervical cancer group were significantly higher than those in cervical epithelial lesion group(all P < 0.05).In the cervical cancer group,there was no significant difference in the positive expression of p16,p53 and Ki-67 in patients with different ages(P > 0.05).However,the positive expression of p16,p53,and Ki-67 increased significantly in patients with different FIGO stages and lymph node metastasis(all P < 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of the combination of p16,p53 and Ki-67 were significantly higher than those of single index.Conclusions The positive expression of p16,p53 and Ki-67 in cervical cancer tissues is related to the disease progression and lymph node metastasis of patients with cervical cancer.The combined detection of the three indicators has important significance in screening and identifying the progression of cervical cancer,and can also improve the clinical diagnostic value and improve the prognosis of patients.