摘要
目的:探讨用p16和p53及Ki-67等免疫组化标记作为宫颈上皮内瘤变(CIN)诊断的辅助指标。方法:选取我院档案CIN患者133例,年龄20～86岁,中位年龄46岁。经3位高年资病理医师复查确认,其中CIN 1级31例、CIN 2级37例和CIN 3级65例。另选同期我院宫颈慢性炎患者19例,浸润性鳞状细胞癌患者20例作为对照。采用SP法进行p16、p53和Ki-67免疫组化染色,结果独立评分。各级别CIN与免疫组化表达的关系采用单变量χ2检验和Spearman等级相关分析。结果:p16阳性表达位于细胞核或胞核伴胞质,p53和Ki-67定位于细胞核。p16、p53和Ki-67表达阳性率随着CIN的加重而升高,均与CIN级别呈正相关,r值分别为0.789、0.554和0.749,P<0.001。153例CIN 1+标本中p16、p53和Ki-67与组织学诊断符合率分别为96.7%(148/153)、71.9%(110/153)和88.2%(135/153)。在102例CIN 2+标本中,p16、p53和Ki-67免疫组化染色的敏感性分别为97.1%(99/102)、74.5%(76/102)和97.1%(99/102);特异性分别为94.7%(18/19)、84.2%(16/19)和73.7%(14/19)。p16、p53和Ki-67 3者联合在CIN 2+中的敏感性和特异性分别为98.0%(100/102)、68.4%(13/19)。结论:在宫颈活检的组织学评价时,结合p16、p53和Ki-67免疫组化染色,对提高高级别CIN的检出率、减少漏诊有很大作用。
OBJECTIVE：To explore immunohistochemistry staining for p16INK4a,p53 and Ki-67 as adjunct indicators for cervical intraepithelial neoplasia（CIN） diagnosis,improving the routine interpretation of cervical histopathology.METHODS：Totally 133 cases of CIN were involoved in this study,which consisted of 31 CIN 1,37 CIN 2,65 CIN 3 from archival data in our hospital.The average age was 44 years（range 20-86 years）.All hematoxylin-eosin slides were reexamined independently by three senior pathologists.Nineteen cases of chronic cervicitis and 20 cases of invasive squamous cell carcinoma were involved as controls.Immunostains for p16INK4a,p53 and Ki-67 were performed.The expressions of immunostain were scored independent of the corresponding SP stained sections and clinical data except age.Statistical analysis was performed by Univariate χ2 tests and Spearman analysis.RESULTS： The expression of p16 was located in nucleus and cytoplasm.For p53 and Ki-67,were located in nucleus.All three biomarkers correlated positively with the grading of CIN（r were 0.789,0.554 and 0.749,P0.001）.In 153 cases of CIN1＋,raw agreement between the expression of p16,p53 and Ki-67,and histological diagnosis was 96.7%（148/153）,71.9%（110/153） and 88.2%（135/153）,respectively.In 102 cases with CIN 2＋,sensitivity for p16,p53 and Ki-67 immunostain was 97.1%（99/102）,74.5%（76/102） and 97.1%（99/102）,respectively.And specificity for these biomarkers was 94.7%（18/19）,84.2%（16/19） and 73.7%（14/19）,respectively.Combined the three biomarkers,the sensitivity and specificity of CIN 2＋ was 98.0%（100/102） and 68.4%（13/19）,respectively.CONCLUSIONS： Immunohistochemical staining for p16 is a high degree of sensitivity,and specificity appears to be a useful and reliable diagnostic adjunct for distinguishing high-grade CIN.It appears that conjunctive interpretation of p16,p53 and Ki-67 can significantly improve the routine interpretation of cervical histopathology.
出处
《中华肿瘤防治杂志》
CAS
2011年第16期1255-1258,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
南通市社会发展科技计划项目(S2009050)
