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。

Expression of p63 and Ki-67 protein in cervical intraepithelial neoplasia and its clinical significance

Objective：To explore the expression of p63 and Ki-67 protein in cervical intraepithelial neoplasia（CIN） and its significance.Methods：One hundred and twenty-six biopsy samples of the cervix were selected,and the expression of p63,Ki-67 protein and human papillomavirus（HPV） was detected by immunohistochemical technique.Among the samples,12 were normal controls,40 CIN1,31 CIN2,33 CIN3 and 10 invasive carcinomas.The invasive carcinomas were probed by low risk（LR）-HPV DNA and high risk human papilloma virus（HR）-HPV DNA using in situ hybridization（ISH） method.Results：The expression of p63 in the control group was negative,but that in the thickening cervical squamous epithelium might present positive cells.In the CIN1,CIN2,CIN3 and invasive carcinoma groups,the positive rates of p63 were 80.0%,96.8%,100.0% and 10/10;the positive rates of Ki-67 protein were 0.0 %,27.5%,64.5%,54.5% and 8/10;the positive rates of HPV were 33.3%,17.5%,51.6%,39.4% and 3/10,respectively.In the invasive carcinomas,the positive rates of LR-HPV DNA and HR-HPV DNA were 5/10 and 8/10,respectively.The expression of p63 in CIN increased obviously with the upgrade of the histopathological degree,and was related with HPV infection（P〈0.05）.Conclusions：The application of p63 combined with Ki-67 protein is of help to the screening,early diagnosis and treatment of cervical precancerous lesions.