HPVLl蛋白、P16和Ki-67在宫颈上皮内瘤变中的表达及意义

目的研究HPVLl蛋白、p16、Ki-67在宫颈上皮内瘤变和宫颈鳞癌中的表达情况，探讨它们在宫颈上皮癌前病变中的预测价值。方法收集宫颈粘液PCR检测HPV阳性、阴道镜活检发现宫颈上皮内病变的100例病例，其中CINI38例，CINII34例，CINⅢ28例，采用免疫组化的方法检测各组宫颈活检标：奉中HPVLl蛋白、p16、Ki-67的表达情况，分析各种蛋白的表达与宫颈病变的关系。结果HPVLl在CINI、CINⅡ、CINIII的表达率分别为55．2％、29．4％、7．1％；P16在CINI、CINⅡ、CINⅢ的表达率分别为39．5％、73．5％．92．9％；Ki-67在CINI、CINII、CINⅢ的表达率分别为76．3％、88．2％、100％。随着宫颈活检病理分级升高，H1’VLl蛋白表达率降低，p16、Ki-67表达率升高，差异有统计学意义。结论HPVLl在CINI中存在低表达，p16、Ki-67在宫颈鳞癌组织CINⅡ、CINⅢ中表达增加，提示可能与宫颈病变的进展有关，联合检测宫颈病变组织中HPVLl蛋白、p16、Ki-67蛋白的表达情况，有望成为预测宫颈病变进展的生物学指标。

The expression and implication of human papilloma virus L1 capsid protein, P16 and Ki-67 in the cervical intraep- ithelial neoplasia

Objective To assess the expression and clinical implication of HPVL1, P16, and Ki-67 in cervical in- traepithelial neoplasia and squamous cell carcinoma, to explore the correlation among these parameters, and to investigate whether these parameters can be used to predict the course of mild or moderate cervical intraepithelial neoplasia. Meth- ods One hundred of specimens of cervical intraepithelial neoplasia （ CIN I , 38 cases ; CIN II , 34 cases ; CIN III, 28 ca- ses） with HPV infection determined by PCR were selected. The expression of HPVL1 capsid protein, P16, and Ki-67 was detected by S-P method of immunohistochemistry. Results The positive rates of HPVL1 in CIN I , CIN II, and CIN III were 55.2 %, 29.4 %, and 7. 1%, respectively, the positive rates of p16 in CIN I ,CIN lI, and CINH[ were 39.5 %, 73.5 %, and 92.9 %, respectively, and the positive rates of Ki-67 in CIN I , CIN I1, and CIN Ill were 76.3 %, 88.2 %, and 100 %, respectively. HPVL1 expression decreased with the severity of pathological lesio：as, whereas p16 and Ki-67 expression increased with pathological lesions. The severity of cervical lesions was negatively correlated with HPVL1 capsid expression, but positively correlated with p16 and Ki-67 expression. Conclusion Down expression of HPVL1 and up expression of p16 and Ki-67 exist in CIN 11 and CIN llI, and are involved in cervical cancer progression. The combination of HPVLI capsid protein, p16 and Ki-67 may be useful in predicting the severity of cervical lesions.