P16~(INK4A)、Ki-67及ER在宫颈病变病理诊断中的应用价值

目的:探讨P16INK4A、Ki-67及ER在不同宫颈病变组织中的表达及其在宫颈病变诊断中的应用价值。方法:采用免疫组化方法检测204例患有宫颈单纯增生鳞化、尖锐湿疣、不同级别宫颈上皮内瘤变(CIN)、宫颈鳞癌中P16INK4A、Ki-67及ER的表达情况。结果:在宫颈单纯增生鳞化、尖锐湿疣、CINⅠ、CINⅡ、CINⅢ、浸润性鳞癌中P16INK4A的阳性表达率分别为0.00%、1.00%、85.19%、90.91%、100.00%、95.45%;Ki-67的阳性表达率分别为1.89%、30.00%、100.00%、100.00%、100.00%、100.00%;ER的阳性表达率分别为96.23%、90.00%、85.19%、12.12%、9.37%、4.55%。CINⅠ、CINⅡ、CINⅢ、鳞癌组中P16INK4A、Ki-67的阳性表达率与单纯增生鳞化、尖锐湿疣组比较差异有统计学意义(P0.05);CINⅡ、CINⅢ、鳞癌组中ER的阳性表达率与CINⅠ、单纯增生鳞化、尖锐湿疣组比较差异有统计学意义(P0.05)。结论:P16INK4A、Ki-67表达增高与宫颈病变严重程度呈正相关,ER表达增高与其呈负相关;P16INK4A、Ki-67及ER免疫组化检测对不同宫颈病变的病理诊断具有一定鉴别诊断价值。

Application value of P16INK4A,Ki-67 and ER in pathological diagnosis of cervical lesions

Objective:To explore the expressions of P16INK4A,Ki-67 and ER in different cervical lesions and their application values in pathological diagnosis of cervical lesions.Methods:The expression levels of P16INK4A,Ki-67 and ER in 204 cases with simple cervical hyperplasia,condyloma acuminata,cervical intraepithelial neoplasia(CIN) of different grades and cervical squamous carcinoma were detected by immunohistochemical method.Results:The positive expression rates of P16INK4A in simple cervical hyperplasia,condyloma acuminata,CINⅠ,CINⅡ,CINⅢ and invasive cervical squamous carcinoma were 0.00%,1.00%,85.19%,90.91%,100.00% and 95.45%,respectively;the positive expression rates of Ki-67 in simple cervical hyperplasia,condyloma acuminata,CINⅠ,CINⅡ,CINⅢ and invasive cervical squamous carcinoma were 1.89%,30.00%,100.00%,100.00%,100.00% and 100.00%,respectively;the positive expression rates of ER in simple cervical hyperplasia,condyloma acuminata,CINⅠ,CINⅡ,CINⅢ and invasive cervical squamous carcinoma were 96.23%,90.00%,85.19%,12.12%,9.37% and 4.55%,respectively.There was significant difference in positive expression rates of P16INK4A and Ki-67 between CINⅠ group,CINⅡ group,CINⅢ group,invasive cervical squamous carcinoma group and simple cervical hyperplasia group,condyloma acuminata group(P<0.05);there was significant difference in positive expression rate of ER between CINⅡ group,CINⅢ group,invasive cervical squamous carcinoma group and CINⅠ group,simple cervical hyperplasia group,condyloma acuminata group(P<0.05).Conclusion:The high expressions of P16INK4A and Ki-67 are positively correlated with severity of cervical lesions,the high expression of ER is negatively correlated with severity of cervical lesions;joint immunohistochemical detection of P16INK4A,Ki-67 and ER has a certain differential diagnostic value in pathological diagnosis of cervical lesions.