p16、Ki-67和CK7在宫颈癌前病变中的表达及临床意义

目的探讨p16蛋白(p16)、Ki-67抗原(Ki-67)及细胞角蛋白7(CK7)在宫颈癌前病变中的表达及临床意义。方法选取2014年1月至2017年3月收治的96例宫颈上皮内瘤样变(CIN)患者的石蜡组织标本,并按病变程度将其分为CINⅠ组(25例)、CINⅡ组(36例)和CINⅢ组(35例),同时选取64例慢性宫颈炎患者的石蜡组织标本为对照组,采用免疫组化SP法检测各组p16、Ki-67和CK7阳性表达率及表达模式,评价其对宫颈癌前病变的诊断效能。结果 CINⅠ组、CINⅡ组和CINⅢ组p16、Ki-67和CK7的阳性表达率均高于对照组,差异有统计学意义(P0.05);p16、Ki-67和CK7表达总评分与宫颈癌前病变程度具有一致性(Kappa值分别为0.546、0.628、0.349);受试者工作特征曲线分析结果显示,p16、Ki-67和CK7联合检测的曲线下面积(0.978)高于各项单独检测(0.930、0.966、0.837),差异有统计学意义(P0.05)。结论 p16、Ki-67和CK7的表达与宫颈病变程度具有相关性,且三者联合检测有利于提高对宫颈癌前病变的诊断效能,可运用于宫颈病变的辅助诊断及高风险进展宫颈癌前病变的预测。

Expression and clinical significance of p16 ,Ki-67 and CK7 in cervical precancerous lesion

Objective To investigate the expression and clinical significance of p16 protein(p16) ,Ki-67 antigen(Ki-67) and cytokeratin 7(CK7) in cervical precancerous lesion .Methods The paraffin embedded tissue samples in 96 cases of cervical intraepithelial neoplasia(CIN) from January 2014 to March 2017 were selected and divided into the CIN Ⅰgroup(25 cases) ,CIN Ⅱgroup (36 cases) and CIN Ⅲ group(35 cases) according to the lesion severity ;meanwhile the paraffin embedded tissue samples in 64 ca-ses of chronic cervicitis were selected as the control group .The positive expression rates and expression modes of p16 ,Ki-67 and CK7 in different degrees of cervical lesion tissue were detected by adopting the immunohistochemistry method .Results The positive expression rates of p16 ,Ki-67 and CK7 in the CINⅠ ,Ⅱand Ⅲgroups were significantly higher than those in the control group , the difference was statistically significant (P＜0 .05) .The total score of p16 ,Ki-67 and CK7 had consistency with the degree of cervical precancerous lesions(Kappavalues were 0 .546 ,0 .628 and 0 .349 respectively) .The receiver operating characteristic curve analysis results showed that the area under the curve of p16 ,Ki-67 and CK7 combined detection was higher than that of single detection of these 3 indexes(0 .978 vs .0 .930 ,0 .966 ,0 .837) ,the difference was statistically significant (P＜0 .05) .Conclusion The expression of p16 ,Ki-67 and CK7 has the correlation with the degree of cervical precancerous lesions .Their joint detection is helpful to improve the diagnostic efficiency of cervical precancerous lesions and could be used in the assisted diagnosis of cervical lesion and prediction of high risk progress cervical precancerous lesion .