摘要
目的分析p16(p16ink4a)、细胞周期因子(geminin)和Ki-67在低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)中的阳性表达水平,进一步探讨上述指标评估LSIL患者病情进展的能力。方法对2015年1月至2018年6月期间上海市嘉定区中心医院的276例宫颈标本资料进行回顾性研究,最终选择148例LSIL患者。根据第二次检查结果将LSIL患者分为3组:(1)无病变(自然消退)组90例;(2)LSIL持续组38例;(3)高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)组20例。取患者第一次活检组织进行免疫组化,计算p16、geminin、Ki-67的相对阳性比。Spearman相关性分析鉴定上述指标与病情进展的相关性;ROC曲线计算各指标的最佳诊断值,并纳入多因素Logistic回归分析,探究上述标志物对患者进展为HSIL风险的评估能力。结果HSIL组患者p16(51.26±17.15)%、geminin相对阳性比(45.92±15.70)%高于LSIL持续组[(43.71±11.84)%、(21.68±14.47)%],及无病变组[(17.92±9.60)%、(0.16±0.03)%],3组间比较差异有统计学意义(F值分别为2.922、2.751,P均<0.05)。Spearman相关性分析结果提示:p16(r=0.27,P=0.014)、geminin(r=0.44,P<0.001)相对阳性比与患者病情进展呈正相关。ROC曲线下,p16、geminin、Ki-67的最佳诊断值分别为38.9%、32.5%和18.6%。多因素Logistic回归分析提示,p16相对阳性比高于38.9%(OR=4.366,P=0.006)、geminin相对阳性比高于32.5%(OR=5.392,P=0.011)的LSIL患者进展为HSIL的风险较高。结论p16和geminin可能是识别LSIL进展患者的有效生物标志物。
Objective To analyze the positive expression levels of p16(p16ink4a),cell cycle factor geminin and Ki-67 in low-grade squamous intraepithelial lesions(LSIL),and to further explore the ability of these indicators to evaluate the progression of LSIL patients.Methods From January 2015 to June 2018,276 cervical specimens from Jiading District Central Hospital of Shanghai were retrospectively studied,and 148 LSIL patients were selected.According to the results of the second examination,LSIL patients were divided into three groups:(1)no lesion(natural regression)group 90 cases;(2)LSIL persistent group 38 cases;(3)high-grade Squamous Intraepithelial Lesion(HSIL)group 20 cases.Immunohistochemistry was performed on the first biopsy tissues and the relative positive ratios of p16,geminin and Ki-67 were calculated.Spearman correlation analysis identified the correlation between the above indicators and the progress of the disease;ROC curve was used to calculate the best diagnostic value of each indicator,and multivariate logistic regression analysis was included to explore the ability of the above indicators to assess the risk of patients progressing to HSIL.Results In the HSIL group,p16(51.26±17.15)%,geminin relative positive ratio(45.92±15.70)%was higher than those in the LSIL group((43.71±11.84)%,(21.68±14.47)%)and regression group((17.92±9.60)%,(0.16±0.03)%).The difference were statistically significant(F=2.922,2.751,all P<0.05).Spearman correlation analysis showed that the relative positive ratio of p16(r=0.27,P=0.014)and geminin(r=0.44,P<0.001)presented a notable positive correlation with the progression of the disease.Under the ROC curve,the best diagnostic values of p16,geminin and Ki-67 were 38.9%,32.5%and 18.6%,respectively.Multivariate logistic regression analysis showed that the relative positive ratio of p16 was higher than 38.9%(OR=4.366,P=0.006),and geminin was higher than 32.5%(OR=5.392,P=0.011)had a higher risk of progression to HSIL.Conclusion p16 and geminin may be effective biomarkers for identifyi
作者
石琴
徐玲
杨荣
孟亚萍
徐晓锋
邱丽华
Shi Qin;Xu Ling;Yang Rong;Meng Yaping;Xu Xiaofeng;Qiu Lihua(Department of Obstetrics and Gynecology,Jiading District Central Hospital Affiliated Shanghai University of Medicine&Health Sciences,Shanghai 201800,China;Department of Pathology,Jiading District Central Hospital Affiliated Shanghai University of Medicine&Health Sciences,Shanghai 201800,China;Department of Obstetrics and Gynecology,Renji Hospital Affiliated Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)
出处
《中国综合临床》
2019年第6期522-527,共6页
Clinical Medicine of China
基金
上海市嘉定区农业和社会事业科研项目(JDKW-2016-W09)。
