阴道镜下宫颈活检联合EGFR、P16、P53蛋白检测诊断宫颈病变价值

目的:探讨宫颈新柏氏技术(TCT)异常者行阴道镜下宫颈活检联合表皮细胞生长因子(EGFR)、P16、P53蛋白检测对宫颈上皮内瘤样病变(CIN)分期及宫颈癌的诊断价值。方法:选取2016年3月-2019年6月本院妇科门诊收治的TCT异常患者450例,通过阴道镜检查及病理活检最终确定112例为宫颈病变患者(病例组),另取同期正常宫颈组织标本60例为对照组。对比两组阴道镜与病理结果,检测两组EGFR、P16、P53蛋白水平。结果:病例组病理结果显示慢性宫颈炎8例(7.1%),CINⅠ36例(32.1%),CINⅡ32例(28.6%),CINⅢ20例(17.9%),宫颈鳞癌16例(14.3%),阴道镜结果与之符合率分别为100.0%、94.4%、90.6%、85.0%、100.0%。随着宫颈病变程度的升级,EGFR、P16、P53蛋白表达率逐渐升高,在正常宫颈上皮中不表达(P<0.05);宫颈癌Ⅰ期11例(68.8%)、宫颈癌Ⅱ期5例(31.3%),EGFR、P16、P53蛋白在不同宫颈癌分期中表达有差异(P<0.05)。结论:TCT异常者行阴道镜下宫颈活检可提高宫颈病变诊断率,联合EGFR、P16、P53蛋白的检测对区别低级别与高级别宫颈上皮内瘤变有临床意义。

Value of cervical biopsy by colposcopy combined with EGFR,P16,and P53 protein detections for diagnosing patients with cervical lesions

Objective:To investigate the value of colposcopy biopsy combined with epidermal cell growth factor(EGFR),P16,and P53 protein detection of patients with abnormal cervical neo-boehner's technique(TCT)for diagnosing the staging of cervical intraepithelial neoplasia(CIN)and cervical cancer.Methods:450 patients with abnormal TCT results were included from March 2016 to June 2019.Among them,112 patients in study group were confirmed CIN by colposcopy and pathological biopsy,and other 60 patients in control group with normal cervical tissue.The results of colposcopy and pathological examination of patients were compared between the two groups.And the expression levels of EGFR,P16 and P53 protein of patients in the two groups were detected by immunohistochemistry.Results:In the study group,the pathological biopsy confirmed that there were 8(7.1%)patients with chronic cervicitis,36(32.1%)patients with CIN Ⅰ,32(28.6%)patients with CIN II,20(17.9%)patients with CIN Ⅲ,and 16(14.3%)patients with cervical squamous carcinoma.The coincidence rates of the colposcopy and the pathological biopsy for diagnosing chronic cervicitis,CIN Ⅰ,CIN Ⅱ,CIN Ⅲ,and cervical squamous carcinoma were 100.0%,94.4%,90.6%,85.0%and 100.0%,respectively.With the escalation of cervical lesions,the expression levels of EGFR,P16 and P53 proteins of the patients increased gradually,which were not expressed in the normal cervical epithelium(P<0.05).There were 11(68.8%)patients with cervical cancer stage Ⅰ and 5(31.3%)patients with cervical cancer stage Ⅱ,and there were significant different in expressions of EGFR,P16 and P53 protein of the patients with different stages of cervical cancer(P<0.05).Conclusion:Colposcopy biopsy can effectively improve the accuracy rate for diagnosing cervical disease of patients with abnormal TCT.And the colposcopy biopsy combined with the expression of EGFR,P16,and P53 proteins levels has clinical significance to distinguish low grade and high grade of cervical intraepithelial neoplasia of patients.