Ki-67、PCNA及HPV在宫颈癌和宫颈上皮内瘤变的表达及意义

目的:研究Ki-67,增殖细胞核抗原(PCNA)在早期宫颈癌(IA~IIA期高分化)、宫颈上皮内瘤变(CINI、CINII、CINIII)及慢性宫颈炎中的表达,及其与HPV感染的关系,探究3者联合应用的诊断价值。方法:应用免疫组织化学S-P法检测宫颈病变中Ki-67、PCNA抗原的表达,PCR反应检测HPV感染,结合临床病理特点分析。结果:慢性宫颈炎、CIN、宫颈鳞癌中Ki-67阳性表达率分别为33.33%、89.19%、100%。PCNA阳性表达率分别为66.67%、97.30%、100%。HPV阳性率分别是13.33%、54.05%、1000%。CINI和CINII/III中Ki-67阳性表达率分别为85.00%、94.12%;PCNA阳性表达率分别为95.00%、100.00%。HPV阳性率分别是30%、82.35%。CIN和宫颈癌中的Ki7、PCNA及HPV的阳性表达与宫颈炎相比,差异均有显著性(P<0.05)。Ki-67及PCNA过表达率在CINII/III组与CINI组间差异显著(P<0.05)。HPV阳性率在CINII/III与CINI之间差异显著(P<0.01)。Ki-67及PCNA表达与HPV感染有相关性(P<0.05)。结论:Ki-67、PCNA抗原过表达与CINII/III和早期宫颈癌显著相关。Ki-67、PCNA表达与HPV感染率相关,联合检测宫颈组织中Ki-67、PCNA的过表达及HPV感染,有助于判断细胞的增殖活性,可作为诊断早期宫颈癌和CINII/III的标记物。

The expression of Ki-67 and PCNA and their association with HPV infection in early-stage cervical carcinoma and CIN

Objective:To investigate the diagnostic value of Ki-67 and PCNA and their association with HPV infection in early-stage cervical carcinoma、CIN and chronic cervicitis.Methods:Immunohistochemical staining(S-P method) was used to detedt Ki-67 and PCNA expressions.HPV was tested by PCR method.Results:The positive expression rates of Ki-67 in cervicitis,CIN and cervical cancer were 33.33%,89.19% and 100.00% respectively.And the positive expression of PCNA were as below as 66.67%,97.30% and 100.00%.Expression of Ki-67 and PCNA in CIN and in cervix carcinoma were significantly different from that one in cervicitis(P<0.05).The intense positive expression of both proteins showed significant difference between CINII/III and CINI.There was significant difference of HPV expression between CINI and CINII/III(P<0.05).Expressions of Ki-67,PCNA were significantly related to HPV infection.Conclusions:Intense expression of Ki-67,PCNA is significantly related to CINII/III and cervical cancer.There is a positive correlation among HPV and Ki-67 expression and among HPV and PCNA expression.Ki-67,PCNA can be used as markers for early diagnosis of cervical cancer together with HPV test.