p16、Ki-67在子宫颈鳞状上皮病变的表达及临床意义

p16是细胞周期减速调整蛋白,人抗增殖细胞核抗原Ki-67是一种细胞增殖的标记物,本文利用免疫组织化学方法检测p16、Ki-67蛋白在经组织学诊断的子宫颈上皮内瘤变(cervical human papillomaviruses CIN)Ⅰ～Ⅲ级与子宫颈非典型鳞化反应性病变中的表达情况,试图探讨p16、Ki-67在子宫颈鳞状上皮病变中的表达及病理诊断意义.     

Correlation between physical status of human papilloma virus and cervical carcinogenesis

The prevalence of human papilloma virus (HPV)-16 in patients with cervical cancer,the physical status of HPV-16 in patients with cervical lesions,and the role of HPV-16 integration in cervi-cal carcinogenesis were investigated.HPV genotyping was performed by using PCR approach with the primer GP5+/GP6+ and type-specific primer on biopsy specimens taken operatively from 198 women.Multiple PCR was done to detect physical status of HPV-16 in a series of cervical liquid-based cytology samples and biopsy specimens obtained from different cervical lesions with HPV-16 infection,includ-ing 112 specimens with cervical cancer,151 specimens with CINⅠ,246 specimens with CINⅡ and 120 specimens with CINⅢ.The results showed that there were 112 cervical cancer samples (56.57% of total cervical cancer patients) with HPV-16 infection.The frequency of HPV-16 pure integration was 65.18% (73/112),56.57% (47/120),23.58% (58/246) and 7.95% (12/151) in cervical cancer,CINⅢ,CINⅡand CINⅠ patients respectively.In situ hybridization was performed on some paraffin-embedded sections of CINⅡ,CINⅢ and cervical cancer to verify the physical status of HPV-16 infection.Sig-nificant difference was observed between cervical cancer and CINⅠ,CINⅡ,CINⅢ in the frequency of HPV-16 integration (P<0.01).It is suggested that HPV-16 is the most prevalent type and is associated with cervical cancer.In the case of HPV-16 infection there are close associations between the severity of cervical lesions and the frequency of HPV-16 integration.The application of testing HPV genotyping and physical status based on detection of HC-Ⅱ HPV DNA would be in favor of predicting the progno-sis of cervical precancerosis and enhancing the screening accuracy of cervical cancer.     

CINⅡ-Ⅲ级年轻患者宫颈组织p16,p21和Ki-67表达的改变

【目的】 探讨宫颈上皮内瘤变(CIN)Ⅱ-Ⅲ级 < 35岁患者宫颈组织中细胞周期素依赖激酶抑制蛋白p16、p21和细胞增殖抗原Ki-67的表达特点。【方法】选择2008年3月至2009年8月广东省人民医院妇科门诊因宫颈疾病就诊患者,第2代杂交捕获试验(HCⅡ)检测高危型人乳头瘤病毒(HPV) DNA负荷量,经活检或手术后病理诊断CINⅡ-Ⅲ级共109例,分为两组,< 35岁组48例,≥ 35岁组61例,并用宫颈组织病理切片进行p16、p21和Ki-67免疫组化检测,比较两组高危型HPV DNA负荷量和p16、p21和Ki-67蛋白表达差异。【结果】 全部病例均检测到高危型HPV DNA,阳性率为100%,但两组HPV DNA负荷量差异无统计学意义[< 35岁组：(498 ± 848 pg/mL,≥ 35岁组:(548 ± 756) pg/mL,P > 0.05];两组间p16阳性表达率无统计学差异(< 35岁组:100%,≥ 35岁组:96.72%,P > 0.05),但 < 35岁组p21和Ki-67表达阳性率(p21:60.42%,Ki-67:91.67%)明显高于 ≥ 35岁组(p21:39.34%,Ki-67:75.41%,P < 0.05)。 【结论】 CIN年轻患者宫颈组织p21和Ki-67表达率升高,可增加p21和Ki-67检测预测宫颈病变进展状态。     

Expression and significance of SHP-2 in human papillomavirus infected cervical cancer

This study investigated the expression and prognostic value of SHP-2 in cervical cancer caused by human papillomavirus (HPV) infection. Forty-five specimens from patients with cervical can-cer (stageⅠ-Ⅲ), 32 specimens from patients with cervical intraepithelial neoplasia (CIN) (Ⅰ, Ⅱ) and 20 normal cervical samples from patients with hysteromyoma were collected in Department of Pathol-ogy for comparison. The expression levels of SHP-2 and IFN-β proteins were detected by using immu-nohistochemistry. The mRNA expression level of SHP-2 was detected by using quantitative real-time polymerase chain reaction (PCR). HPVs were detected by HPV GenoArray Test. The Spearman corre-lation was used to compare the expression level of SHP-2 in HPV infected cervical cancer vs non-HPV infected normal cervix. The level of SHP-2 protein expression in the cancer tissues (88.8%) was sig-nificantly higher than in CIN tissues (62.5%) and normal cervixes (45%) (P<0.05 and P<0.05, respec-tively). The SHP-2 mRNA levels in the cancer tissues were upregulated as compared with those in the normal cervixes (P<0.05). Twenty-one (46.7%) cervical cancers, 25 (78.1%) CINs and 17 (85%) normal cervixes showed IFN-β positive staining in cytoplasm. There was statistically significant difference in the expression rate of IFN-β between cervical cancer and normal cervix (χ2=8.378, P<0.05) as well as between cervical cancer and CIN (χ2=7.695, P<0.05). HPV16/18 infections could be found in normal cervixs (15%), CINs (68.7%) and cervical cancers (84.4%). There was a correlation between HPV in-fection and SHP-2 expression in cervical cancer (rs=0.653, P<0.05). SHP-2 may be a useful prognostic and diagnostic indicator for HPV infected cervical cancer. In cervical cancers, SHP-2 mRNA and pro-tein overexpression was associated with IFN-β lower-expression.     

Telomerase activity in cervical intraepithelial neoplasia

Background It was reported that telomerase expression is closely associated with cellular immortality and cancer. This study was designed to investigate the relationship between telomerase expression and the carcinogenesis of cervical cancer, the possible use of telomerase as a marker of cervical intraepithelial neoplasia (CIN) progression or regression, and the natural history of CIN.Methods Telomeric repeat amplification protocol (TRAP) assay was used to measure telomerase activity in cervical scrapings and biopsy samples obtained from 105 cases affected with various cervical conditions, including chronic cervicitis (n =20), CIN (n =64, 16 cases of CIN Ⅰ , 20 cases of CIN Ⅱ, and 28 cases of CIN Ⅲ）, and invasive squamous cell carcinoma ( n =21 ).Results In exfoliated cell samples, telomerase activity was detected in 5 of 20 (25.0%) cases of cervicitis, 10 of 16 (62.5%) cases of CIN Ⅰ , 11 of 20 (55.0%) cases of CIN Ⅱ, 23 of 28 (82. 1%) cases of CIN Ⅲ, and 13 of 21 (61.9%) cases of carcinoma. In cervical biopsy samples, telomerase activity was detected in 6 of 20 (30.0%) cases of cervicitis, 8 of 16 (50.0%) cases of CIN Ⅰ, 9 of 20 (45. 0%) cases of CIN Ⅱ, 27 of 28 (96.4%) cases of CIN Ⅲ, and 20 of 21 (95.2%) cases of carcinoma. Telomerase activation was significantly higher in CIN samples than in cervicitis samples.Telomerase activity was detected at similar frequency in samples from cervical scrapings and cervical biopsies.Conclusion These results seem to suggest that telomerase expression may be associated with carcinogenesis of the cervix. TRAP assay of cervical scraping samples could be used to monitor and predict the development of CIN in clinical practice.     

细胞块上检测P16、HPV16用于筛查ASCUS中高度宫颈上皮内瘤变的临床探讨

目的 探讨利用细胞块技术,检测宫颈脱落细胞P16、HPV16表达在筛查ASCUS中高度宫颈上皮内癌变的意义.方法 选取TCT检测为ASCUS的120例患者,所有患者均行阴道镜下宫颈活检,取其TCT保存液中的剩余物质制备宫颈细胞块,然后,在细胞块上进行P16、HPV16免疫组化染色.结果 1)120例ASCUS患者经阴道镜下宫颈活检病理学诊断结果为:宫颈炎64例,CIN Ⅰ 33例,CIN Ⅱ 17例,CINⅢ 16例,其中高度官颈上皮、内瘤变者(CIN Ⅱ、CINⅢ)为23例,占19.17%.2)ASCUS中P16阳性表达在宫颈炎组、CIN Ⅰ组、CIN Ⅱ组、CINⅢ组分别为6.25%、51.52%、82.35%、83.33%.P16阳性表达率在宫颈炎组与ClN Ⅰ组,CIN Ⅱ组,CINⅢ组之间比较均有显著性差异(P<0.01).以P16强阳性表达为判定标准,则检出高度宫颈上皮内瘤变的敏感性、特异性、阳性预测值、阴性预测值分别为78.26%、92.78%、72%、94.74%.3)Ascus中HPV16阳性表达率在官颈炎组、CIN Ⅰ组、CINⅡ组、CINⅢ组分别为21.88%、39.39%、76.47%、83.33%,HPV16阳性表达率在宫颈炎组与CINⅡ组、CINⅢ组,CIN Ⅰ组与高度宫颈上皮内瘤变组之间比较,均有显著性差异(P<0.01).结论 细胞块上检测P16,HPV16可用于ASCUS中高度宫颈上皮内瘤变筛查.     

宫颈上皮内瘤变及宫颈鳞癌中Ki-67的表达与高危型HPV感染相关性的研究

目的通过检测Ki-67在宫颈上皮内瘤变(CIN)及宫颈鳞癌中的表达与高危型HPV感染的相关性研究,探讨Ki-67能否成为CIN预后指标之一。方法对147例CIN病变上皮、29例宫颈鳞癌上皮和30例正常宫颈上皮行高危型HPV检测,并用免疫组化染色检测Ki-67表达情况。结果①随着病变的加重,Ki-67的平均灰度值逐渐提高(CINⅡ组除外)。宫颈鳞癌组的Ki-67的平均灰度值与其他各组比较有统计学差异(P<0.05),CINⅠ、Ⅲ组与对照组比较有统计学差异(P<0.05),CINⅢ组与CINⅡ组比较有统计学差异(P<0.05)。②高危型HPV在对照组、CINⅠ-Ⅲ组、宫颈鳞癌组中表达阳性率分别为0,52.63%,58.82%,82.05%,100%,除CINⅡ组与CINⅠ组比较无统计学差异(P>0.05),其余各组间高危型HPV阳性率比较均有统计学差异(P<0.05)。③Ki-67与高危型HPV感染呈正相关(r=0.228,P<0.05)。结论 Ki-67可能成为高危型HPV感染患者的CIN预后指标之一。     

E-cadherin、p16及Ki67在宫颈上皮内瘤变诊断中的应用

目的探讨联合检测E-cadherin、p16、Ki67的表达在子宫颈上皮内瘤变(CIN)中的诊断价值。方法采用免疫组织化学方法检测20例正常宫颈组织、40例CINⅠ、40例CINⅡ及40例CINⅢ中的E-cadherin、p16和Ki67的表达。结果 E-cadherin在正常宫颈、CINⅠ、CINⅡ、CINⅢ中的表达率分别为100%,80%,40%,37.5%;p16在正常宫颈、CINⅠ、CINⅡ、CINⅢ中的表达率分别为0,65%,87.5%,95%;Ki67在正常宫颈、CINⅠ、CINⅡ、CINⅢ中的表达率分别为0,82.5%,92.5%,100%。在低级别上皮内瘤变CINⅠ中,E-cadherin表达于细胞膜,p16表达在上皮的下1/3,Ki67增殖指数较低;在高级别上皮内瘤变CINⅡ-Ⅲ中,E-cadherin异常表达于细胞膜和细胞质,p16弥漫表达于上皮的2/3到上皮全层,Ki67增殖指数较高。结论生物标志物E-cadherin、p16及Ki67对准确地诊断宫颈上皮内瘤变及其分级,并且评估病变的发展具有重要意义。     

HPV L1壳蛋白在宫颈脱落细胞中的表达及临床意义

目的 探讨人乳头状瘤病毒(HPV)L1壳蛋白在宫颈不同病变脱落细胞中的表达和临床意义.方法 收集2008年1月至2009年5月到北京大学深圳医院宫颈门诊就诊患者的宫颈脱落细胞标本309例,其中正常或慢性宫颈炎33例、宫颈上皮内瘤变(CIN)I级168例、CIN Ⅱ/Ⅲ级84例和鳞状细胞癌(SCC)24例,用免疫细胞化学法检测HPV L1壳蛋白在宫颈脱落细胞中的表达.结果 在正常宫颈或慢性宫颈炎、CINI、CINⅡ/Ⅲ和SCC中,HPV L1壳蛋白阳性表达率分别为27.3%(9/33)、66.7%(112/168)、25.0%(21/84)、0%(0/24).其中CINI组、SCC组与正常或慢性宫颈炎组比较,CINI组与CINⅡ/HI组比较,CINI、CINⅡ/Ⅲ组与SCC组比较差异均有统计学意义(均P<0.01),随病变程度的加重,HPV L1壳蛋白阳性表达率呈下降的趋势.分别以30岁和40岁为界分组,不同年龄组间HPV L1壳蛋白的表达差异均无统计学意义(均P>0.05).在高危型HPV DNA负荷量≥1 000 RLU/PC组HPV L1壳蛋白表达率为73.1%,与负荷量<1 000 RLU/PC的各组相比,其表达率明显增加(均P<0.05).HPV L1壳蛋白检测CINⅡ/Ⅲ以上病变的敏感度、特异度、阳性预测值和阴性预测值分别为80.6%、60.2%、52.1%和85.2%.结论 HPV L1壳蛋白在CIN和SCC中的阳性表达率随着病变程度加重呈下降趋势,有望成为预测宫颈癌前病变进展的生物学标志物.     

E2F-1与p16在宫颈上皮内瘤变和宫颈鳞癌中的表达及临床意义

目的研究细胞周期调控因子E2F-1和p16蛋白与宫颈上皮内瘤变及宫颈鳞癌的表达及其临床意义。方法通过免疫组化SP法检测宫颈上皮内瘤变Ⅰ-Ⅱ级(CINⅠ-Ⅱ级)、宫颈上皮内瘤变Ⅲ级(CINⅢ级)、宫颈鳞癌各40例中E2F-1和p16蛋白的表达情况,并用20例慢性宫颈炎组织作对照。结果 E2F-1蛋白在CINⅠ-Ⅱ级、CINⅢ级和宫颈鳞癌组中阳性率分别为17.5%、67.5%和80.0%,3组间有差异(χ2=37.278,P<0.001)。p16蛋白表达阳性率分别为27.5%、70.0%和82.5%,3组间差异有统计学意义(χ2=27.708,P<0.001)。CINⅠ-Ⅱ级与CINⅢ级组及宫颈鳞癌组比较均有差异,但CINⅢ级与宫颈鳞癌组间无差异。p16蛋白的表达与E2F-1蛋白表达有正相关关系;在鳞癌组中E2F-1与p16的异常表达与组织学分级、临床分期有关(P<0.05)。结论子宫颈鳞癌的形成与E2F-1、p16蛋白过表达是呈正相关关系,E2F-1、p16蛋白可能作为子宫颈鳞癌及CIN的标志物,对子宫颈癌筛查和预防有重要意义。     

宫颈上皮内瘤变p16、p53、Ki-67的表达与高危型HPV感染及其临床意义

目的 研究p16、p53、Ki-67在宫颈上皮内瘤变(CIN)中的表达,探讨其与高危型HPV感染的关系及临床意义.方法 利用自制组织芯片对243例CIN病变上皮和30例正常上皮行免疫组化染色检测p16、p53及Ki-67表达情况,部分CIN病例用基因杂交捕获法检测高危型HPV感染情况.结果 正常鳞状上皮与腺上皮p16、Ki-67和p53染色均为阴性,而在CIN中三者均有较高表达,且随CIN级别升高而表达增强,各组间有差别并与CIN分级呈正相关(P＜0.001).同时二者阳性表达均见分层现象,在CIN1中大部分阳性细胞局限于宫颈鳞状上皮的下1/3,在CIN2中累及上皮下2/3,而CIN3则多超过上皮的下2/3或全层弥漫阳性,各组间有差别且与CIN分级呈正相关(P＜0.001).p53的阳性率及表达强度从CIN1到CIN3逐渐增加,多组之间及CIN1与CIN2比较有差别且与CIN分级呈正相关(P＜0.001),但CIN2与CIN3之间无差别.部分CIN1、CIN2及CIN3患者高危型HPV-DNA阳性率分别为37/52(71.2%)、50/58(86.2%)和50/55(90.9%),DNA相对含量多组之间及CIN1与CIN2比较有差别并与CIN分级呈正相关(P＜0.001),CIN2与CIN3之间无差别.结论 高危型HPV感染及p16、Ki-67及p53与宫颈癌前病变发生机制及病变进展相关,而联合检测p16蛋白和Ki-67抗原表达可作为CIN分级诊断的辅助方法,有较好的应用价值.     

宫颈鳞状上皮病变中HPV感染与P16、Ki-67蛋白表达

目的：探讨HPV在宫颈鳞状上皮病变中的感染情况及其与P16、Ki-67蛋白表达的关系。方法：采用原位杂交及免疫组化方法,检测HPV、P16和Ki-67蛋白在200例不同程度宫颈鳞状上皮病变中的表达情况。结果：HPV在宫颈鳞状上皮病变中总检出率为64%（128/200）,HPV 6/11在尖锐湿疣组中检出率最高,HPV 16/18在宫颈鳞状细胞癌、CIN组中尤其在CINⅡ～Ⅲ组中阳性率显著性增高。随着宫颈病变程度的加重,P16和Ki-67蛋白的阳性表达也呈递增趋势。结论：高危型HPV16/18感染与宫颈鳞状上皮内瘤变密切相关;抑癌基因P16蛋白的表达上调参与蛋白对宫颈鳞状细胞癌的发生发展过程;P16蛋白还可作为鉴别宫颈肿瘤性及非肿瘤性增生的标记物;联合检测P16和Ki-67蛋白对宫颈CIN的诊断及分级具有辅助诊断价值。     

核增殖抗原和生存素蛋白在胃肠道间质瘤中的表达与意义

目的 探讨核增殖抗原(Ki-67)和生存素(survivin)蛋白在胃肠道间质瘤(GIST)中的表达及临床意义.方法 应用免疫组化SP法和病理图像分析系统检测85例胃肠道间质瘤(GIST)患者中Ki-67和survivin的表达情况,结合临床病理学资料分组比较并进行统计学分析.结果 85例GIST中Ki-67和survivin表达的平均灰度值在良性组、潜在恶性组、恶性组中依次递减, 即它们的阳性表达水平逐渐增高.三组两两比较,各组的平均表达水平差异有统计学意义(P<0.05).而且在41个恶性病例中,有浸润或转移的亚组的Ki-67和survivin表达水平显著高于无浸润转移亚组的表达水平(P<0.05).同时统计分析表明GIST中Ki-67和survivin表达有显著的正相关性(P<0.01).结论 Ki-67和survivin高表达导致肿瘤细胞的增殖旺盛和凋亡抑制是GIST发生恶变以及向外侵袭转移的重要机制之一,两者可能用以协助判断GIST的良恶性以及预测肿瘤转移及预后. Abstract： Objective To investigate the expression of Ki-67 and survivin in gastrointestinal stomal tumors (GIST) and their clinical pathologic significance. Methods The expression of Ki-67 and survivin were detected in 85 cases of GIST by immunohistochemical technique. Futhermore,multi-function precise color-image measure system was used for quantitative analysis.The relationship between expression and clinical pathologic data was analyzed.Results Among 85 GISTs, the expression of Ki-67 and survivin in benign,potentially malignance and malignance group were increased gradually.There was a significant difference among the groups of each gene's expression(P<0.05). There was also significant difference in the expression of Ki-67 and survivin between the metastasis subgroup and the non-metastasis subgroup. There was significant positive correlation between Ki-67 and survivin expression(P<0.05). Conclusions The unbalance of the cell proliferation and apoptosis resulted by the increased expression of Ki-67 and survivin is one of the important mechanism in carcinogenesis process and invasion and metastasis of GIST. The expression of Ki-67 and survivin maybe can serve as an important predicting maker for malignancy degree and metastasis and prognosis of GIST.     

p16,pRb和Ki-67在宫颈鳞癌中的表达及其意义

[目的]观察p16,pRb和Ki-67在宫颈鳞癌中的表达,并探讨其临床意义.[方法]采用免疫组织化学EnVision法检测p16,pRb及Ki-67在35例宫颈鳞癌、36例宫颈上皮内瘤变(10例CIN I,26例CINⅡ/Ⅲ)及35例正常宫颈鳞状上皮黏膜组织中的表达水平.[结果]p16及Ki-67蛋白阳性表达率在宫颈鳞...     

p16、p53、Ki-67和血清SCC-Ag在宫颈鳞癌中的表达及意义

目的 探讨p16、p53、Ki-67和血清鳞状细胞癌抗原(squamous cell carcinoma antigen, SCC-Ag)在宫颈鳞癌患者中的表达及意义。方法 采用免疫组织化学法检测31例宫颈鳞癌与31例宫颈炎组织中p16、p53、Ki-67的表达,同时采用化学发光微粒子免疫法检测治疗前的血清SCC-Ag水平。结果(1) 宫颈炎和宫颈鳞癌中p16、p53、Ki-67、SCC-Ag的阳性率分别为0%、0%、12.9%、0%和96.8%、48.4%、100%、71%,两组比较有显著差异(P<0.05)。(2) p53高表达与淋巴结或脉管转移有关,Ki-67表达随组织学分级升高而升高,血清SCC-Ag水平随临床分期升高而升高(P<0.05)。(3) 经Spearman等级相关分析,p16染色强度与血清SCC-Ag水平呈正相关(r=0.467,P<0.05),在临床Ⅰ期宫颈鳞癌中,两者间正相关更显著(r=0.59,P<0.05)。结论 P53、Ki-67、血清SCC-Ag与宫颈鳞癌发展的恶性程度相关,其在表达上的差异与肿瘤生物学行为有一定关系,宫颈鳞癌在发生发展过程中,尤其是早期阶段,p16与血清SCC-Ag可能有协同作用。     

细胞免疫化学p16/Ki-67双染结合DNA倍体分析预测HSIL的研究

目的 探讨DNA倍体分析联合细胞免疫化学p16/Ki-67双染检测对宫颈高级别鳞状上皮内病变(HSIL)及宫颈鳞癌(SCC)的诊断价值.方法 随机收集细胞学检查73例,其中有少量DNA倍体异常细胞53例,DNA倍体阴性20例,通过细胞免疫化学双染检测p16/Ki-67结果.以病理结果为金标准,对比分析DNA倍体分析和DNA倍体分析联合p16/Ki-67双染对HSIL+的诊断价值.结果 20例DNA倍体阴性的标本中p16/Ki-67双染结果全部阴性.DNA倍体分析对HSIL+的阳性预测值为34.62％,DNA倍体分析联合p16/Ki-67双染对HSIL+的敏感性为84.62％,特异性为92.31％,阳性预测值为78.57％,阴性预测值为94.74％,明显高于DNA倍体分析对HSIL+的阳性预测值(P＜0.05).结论 p16/Ki-67双染可以明显提高HSIL检出的预测值,DNA倍体分析联合p16/Ki-67双染是预测HSIL+的有效方法,适合在医疗资源缺乏的地区实施.     

P16INK4A、Ki-67和HPV DNA16/18在绝经后妇女宫颈鳞状上皮病变中表达的意义

目的探讨P16INK4A、Ki-67及高危型人乳头状瘤病毒在绝经后妇女宫颈萎缩及不同程度鳞状上皮病变中的表达及临床病理意义。方法采用原位杂交及免疫组化方法,检测人乳头状瘤病毒的HPV DNA16/18,P16INK4A、Ki-67蛋白在104例萎缩和不同程度宫颈病变组织中的表达情况。结果HPVl6/18在不同程度宫颈病变中总检出率为28.57%(24/84);在CINⅡ/Ⅲ级、宫颈鳞癌组中阳性表达率较高。随着宫颈病变严重程度的增加,P16INK4A、Ki-67的阳性表达率及染色强度呈递增趋势。P16INK4A、Ki-67与HPVl6/18型感染关系密切。萎缩病变HPVl6/18、P16INK4A、Ki-67为阴性表达。结论P16INK4A、Ki-67可以作为绝经后宫颈HPV感染有关的肿瘤性病病变的标记物,对区分绝经后宫颈萎缩及上皮内瘤变有重要意义。     

p63和Ki-67蛋白在子宫颈上皮内瘤变中的表达及其临床意义

目的: 探讨子宫颈上皮内瘤变(CIN)组织中p63和Ki-67蛋白的表达及其临床意义。方法: 选择126例子宫颈活检组织标本,采用免疫组织化学技术检测p63、Ki-67和人乳头状瘤病毒(HPV)表达,其中12例正常子宫颈组织为对照组,CIN1 40例、CIN2 31例、CIN3 33例及浸润性癌组织10例。对浸润性癌用原位杂交技术(ISH)加做低危型和高危型HPV DNA检测。结果: 对照组组织中p63呈阴性,但在增厚的鳞状上皮可出现阳性细胞。在CIN1、CIN2、CIN3和浸润性癌组织中,p63阳性率分别为80.0%、96.8%、100.0%和10/10,Ki-67蛋白阳性率分别为0.0%、27.5%、64.5%、54.5%和8/10,HPV阳性率分别为33.3%、17.5%、51.6%、39.4%和3/10,差异均有统计学意义(P < 0.05~P < 0.01)。在浸润性癌组织中低危型和高危型HPVDNA阳性率分别为5/10和8/10。p63在CIN组织中表达强度随病理分级明显增强,且与HPV感染有相关关系(P < 0.05)。结论: p63和Ki-67蛋白联合检测,有助于子宫颈癌前病变的筛查、早期诊断和治疗。     

p16、Ki-67在尖锐湿疣中的表达及其临床意义

目的:探讨p16、Ki-67在尖锐湿疣术前及术后皮损中的表达,分析其临床意义。方法:SP法检测p16、Ki-67在尖锐湿疣患者术前、术后复发及未复发者标本中的表达。结果:p16、Ki-67在尖锐湿疣患者术前标本中的阳性率分别为76%、100%;在术后复发标本中的阳性率分别为25%、100%;在术后未复发者标本中的阳性率分别为7.69%、69.23%。p16、Ki-67在术后复发者与未复发者阳性表达率有显著性差异(P<0.05)。结论:尖锐湿疣术后复发与其自身的生物学活性有关,检测p16、Ki-67抗原表达可作为判断尖锐湿疣预后的一种方法。