P16和Ki-67在宫颈鳞癌癌前病变中的表达及其诊断价值

目的研究P16和Ki-67在宫颈鳞状上皮内瘤变（CIN）中的表达，探讨它们在CIN诊断和分级中的价值。方法采用免疫组化EnVision法检测10例慢性宫颈炎、16例低级别CIN和25例高级别CIN中P16和Ki-67的表达。结果P16在慢性宫颈炎中表达阴性或仅散在表达，低级别和高级别CIN中强阳性表达率分别为25％和80％，差异有显著性（P〈0．01）。随着宫颈病变的加重，Ki-67表达上移且阳性率增高，差异有显著性（P〈0．05）。P16在区分慢性宫颈炎和低级别CIN的敏感性和特异性分别为25％和100％，区分低级别CIN和高级别cIN的敏感性和特异性分别为80％和75％。Ki-67在区分慢性宫颈炎和低级别CIN的敏感性和特异性分别为0％和90％，在区分低级别CIN和高级别CIN的敏感性和特异性均为100％。P16／Ki-67联合检测在区分宫颈慢性炎和低级别CIN中敏感性和特异性分别为25％和90％，而在区分低级别CIN和高级别CIN中敏感性和特异性分别为100％和75％。结论P16和Ki-67联合检测可有助于宫颈鳞状上皮内病变的诊断和分级。

Expression and Diagnostic Value of P16 and Ki-67 in Precancerous Lesions of Cervical Sqamous Cell Carcinoma

Objective To study the expression of P16 and Ki-67 in cervical intraepithelial neoplasia（CIN）, and to explore the value of them in the diagnosis and grade of CIN. Methods The expression of P16 and Ki-67 are detected by immunohistochemical staining EnVision in 10 cases of chronic cervicitis, 16 cases of low-grade CIN and 25 cases of high-grade CIN. Results The negative and sacttered expression of P 16 is observed in chronic cervicitis, but the positive rates of P16 in low-grade and high-grade CIN are 25% and 80%. There is significant difference（P〈0.01）. With exacerbation of cervical lesions, Ki-67 expresses upward and positive rate becomes increase, there is significance（P〈0.05）. The specificity and sensitivity of P16 in distinguishing chronic cervicitis from low-grade CIN are 25% and 100%, the specificity and sensitivity in distinguishing low-grade CIN from high-grade CIN are 80% and 75%. The specificity and sensitivity of Ki-67 in distinguishing chronic cervicitis from low-grade CIN are 0% and 90%, in lowgrade CIN from high-grade CIN are both 100%. The specificity and sensitivity of P16 combined with Ki- 67 in distinguishing chronic cervicitis from low-grade CIN are 25% and 90%, in low-grade CIN from high-grade CIN are 100% and 75%. Conclusion The detection of P16 combined with Ki-67 may be helpful for the diagnosis and grade of CIN.