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目的研究P16和Ki-67在宫颈上皮内瘤变组织中的表达及与高危型人乳头瘤病毒(HPV)的关系和临床意义。方法应用免疫组织化学方法检测2005年9月至2007年8月间广东省人民医院40例正常宫颈组织、103例宫颈上皮内瘤变(CIN)及56例宫颈浸润癌中P16和Ki-67的表达,并采用第二代杂交捕获试验(HC-Ⅱ)检测高危型HPVDNA。结果P16和Ki-67的表达强度与CIN的严重程度分别呈正相关(P<0.01)。P16和Ki-67在CINⅡ、CINⅢ、宫颈鳞癌及腺癌中表达呈阳性至强阳性的比例,明显高于正常宫颈组织及CINⅠ,差异有统计学意义(P<0.01)。高危型HPV感染阳性率88.9%(177/199),其中正常宫颈42.5%、CINⅠ87.5%、CINⅡ与CINⅢ均100%、宫颈鳞癌98.0%、腺癌60.0%。高危型HPVDNA负荷量与P16、Ki-67的表达强度分别呈正相关(P<0.01)。结论P16和Ki-67的表达强度与CIN的严重程度以及高危型HPVDNA负荷量密切相关;P16和Ki-67可作为诊断CINⅡ及CINⅢ的重要辅助指标。
Objective To study the expression of P16 and Ki-67 in cervical intraepithelial neoplasia and its relationship with high risk human papillomavirus (HPV) and its clinical significance. Methods Immunohistochemistry was used to detect the expression of P16 and Ki-67 in 40 cases of normal cervical tissue, 103 cases of cervical intraepithelial neoplasia (CIN) and 56 cases of invasive cervical carcinoma in Guangdong Provincial People’s Hospital from September 2005 to August 2007. The second generation hybridization capture assay (HC-Ⅱ) was used to detect high-risk HPVDNA. Results The expressions of P16 and Ki-67 were positively correlated with the severity of CIN (P <0.01). The positive rates of P16 and Ki-67 in CINⅡ, CINⅢ, cervical squamous cell carcinoma and adenocarcinoma were significantly higher than those in normal cervical tissue and CINⅠ (P <0.01). The positive rate of high-risk HPV infection was 88.9% (177/199), with 42.5% of normal cervix, 87.5% of CINⅠ, 100% of CINⅡ and CINⅢ, 98.0% of cervical squamous cell carcinoma and 60.0% of adenocarcinoma. The high-risk HPVDNA load was positively correlated with the expression of P16 and Ki-67 (P <0.01). Conclusions The expression of P16 and Ki-67 is closely related to the severity of CIN and the load of high-risk HPVDNA. P16 and Ki-67 may serve as important auxiliary indexes for diagnosis of CINⅡ and CINⅢ.