宫颈脱落细胞中cyclin E和Ki67的表达及意义

目的:探讨宫颈脱落细胞中cyclinE、Ki67的表达对宫颈癌高危人群筛查的意义。方法:采用免疫组化法对78例(不明意义的鳞状上皮非典型增生12例,宫颈上皮内瘤样病变CINⅠ17例、CINⅡ~Ⅲ38例、浸润癌11例)宫颈脱落细胞标本进行cyclin E、Ki67检测。结果:cyclin E、Ki67在CINⅠ、CINⅡ~Ⅲ以及浸润癌标本中的阳性率均较ASCUS组高,差异有统计学意义,P<0·005;CINⅠ组cyclin E的表达高于其他各组;Ki67的表达随着宫颈上皮细胞损伤程度加重而上升,浸润癌标本中阳性率最高;在CINⅠ组cyclin E和Ki672项指标特异度均为91·7%,灵敏度cyclin E(94·1%)高于Ki67(47·1%)。结论:采用宫颈脱落细胞检测cyclin E、Ki67作为辅助诊断指标应用于宫颈癌高危人群筛查,具有重要意义。

Expressions of cyclin E and Ki67 in cervical exfoliated cells for screening cervical carcinoma

OBJECTIVE:To evaluate the significance of cyclin E and Ki67 overexpressions in cervical exfoliated cells for screening patients at high risk of developing cervical carcinoma. METHODS: By the immuohistochemicalnalysis method, cyclin E and Ki67 in cervical exfoliated cells were delected in 78 cervical exfoliated epithelial samples, which were atypical squamous cells of undetermined significance (ASCUS ,12 cases), cervical inter-aepithelial neoplasia(CIN) of type 1 (17 cases), CIN2-3 (38 cases) and invasive carcinoma (11 cases) respectively.RESULTS: Cyclin E and Ki67 were all overexpressed in cervical preneoplasial and neoplasial cells, compared with those in ASCUS, P<0.005. The expression of Ki67 in cervical preneoplasial and neoplasial cells correlated well with cervical neoplasia, P<0.005. Cyclin E was overexpressed in CIN1 (94.1%, P<0.01), and Ki67 was overexpressed in invasive carcinoma (90.9%).CONCLUSION:The employment of cyclin E and Ki67 in combination for the primary screening of cervical cytology could not only reduce both the higher false-positive and false-negative rate of conventional Pap test, but increase its specificy and sensitivity.