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目的:探讨宫颈液基细胞中p16INK4a和cyclin E蛋白表达及其对CINI患者预后的评估价值。方法:收集我院病理科2005-10/2008-10液基细胞学诊断CIN Ⅰ级患者86例,均经病理组织学证实为CIN Ⅰ级。采用免疫细胞化学染色检测p16INK4a及cyclin E蛋白,同时随访1年,观察其表达与患者病情转归的相关性。结果:86例CIN Ⅰ级患者宫颈液基细胞中p16INK4a阳性表达59例(68.6%),cyclin E阳性表达70例(81.4%)。随访1年,54例CINI病变治愈,21例CIN Ⅰ病变未愈,11例进展为CIN Ⅱ及CIN Ⅲ(恶化)。59例pl6INK4A阳性表达病例中28例治愈,20例未愈,11例恶化;而27例pl6INK4A表达阴性者中26例治愈,1例仍未愈,均无恶化。两者比较有统计学差异(P<0.01)。70例cyclin E阳性表达病例中29例治愈,26例未愈,15例恶化;而16例cyclin E表达阴性者均治愈。两者比较有统计学差异(P<0.01)。结论:p16INK4a及cyclin E蛋白联合检测对判断宫颈CIN Ⅰ患者预后可能具有重要的临床价值。
Objective: To investigate the expression of p16INK4a and cyclin E in cervical liquid-based cells and their prognostic value in patients with CINI. Methods: Totally 86 patients with CIN Ⅰ grade diagnosed by liquid-based cytology from October 2005 to October 2008 were confirmed as CIN Ⅰ by histopathology. Immunocytochemical staining was used to detect p16INK4a and cyclin E protein, followed up for 1 year. The correlation between the expression of p16INK4a and cyclin E was observed. Results: The positive expression rate of p16INK4a in cervical liquid group was 59 (68.6%) in 86 CIN Ⅰ patients and 70 (81.4%) in cyclin E positive. One year follow-up, 54 cases of CINI lesion were cured, 21 cases of CIN Ⅰ lesion did not heal, 11 cases of progression to CIN Ⅱ and CIN Ⅲ (deterioration). In the 59 cases of p16INK4A positive expression, 28 cases were cured, 20 cases were unhealed and 11 cases were deteriorated; while in the 27 cases with p16INK4A negative expression, 26 cases were cured and 1 case was still unhealed. The difference was statistically significant (P <0.01). Of the 70 cases with cyclin E positive expression, 29 cases were cured, 26 cases were cured and 15 cases were deteriorated. However, 16 cases with negative cyclin E expression were cured. The difference was statistically significant (P <0.01). Conclusion: The combined detection of p16INK4a and cyclin E protein may have important clinical value in judging the prognosis of cervical CIN Ⅰ patients.