摘要
目的探讨宫颈活检病灶组织中P16和Ki-67蛋白在高危人乳头瘤病毒(HPV)感染同时液基薄层细胞学(TCT)检测异常的患者中阳性表达情况,以及预测早期宫颈癌发生的应用价值。方法回顾性总结2016年1月至2017年7月于临海市中医院行HPV-DNA检测和TCT检查患者,选择高危HPV(16和18亚型阳性)和TCT异常患者共120例,经阴道镜宫颈活检病灶组织进行病理诊断,同时进行P16和Ki-67蛋白免疫组化染色。结果120例患者中HPV-16阳性66例,18阳性34例,16和18均阳性20例;TCT报告未明确诊断意义的非典型鳞状上皮细胞(ASC)6例,低级别鳞状上皮内病变(LSIL)46例,高级别SIL(HSIL)60例,宫颈鳞状细胞癌(SCC)8例;病理诊断炎症5例,上皮内瘤样病变(CIN)105例,SCC 10例。P16和Ki-67蛋白阳性表达率在炎症、CIN和SCC患者中逐渐升高[0.0%(0/5)、36.2%(38/105)、70.0%(7/10),χ^2=4.382,P=0.036;0.0%(0/5)、40.0%(42/105)、80.0%(8/10),χ^2=5.945,P=0.015]。对CIN患者共随访21~36个月,中位时间29.5个月,共26例进展至SCC,进展至SCC患者随访截止时P16和Ki-67蛋白阳性表达率显著高于未进展患者[61.5%(16/26)比39.2%(31/79),χ^2=3.934,P=0.047;69.2%(18/26)比41.8%(33/79),χ^2=5.905,P=0.015]。结论宫颈活检组织中P16和Ki-67蛋白在高危HPV感染同时TCT异常患者中具有差异性表达,病理诊断SCC中P16和Ki-67蛋白阳性表达率显著高于CIN患者,并且随访进展至SCC的CIN患者P16和Ki-67蛋白阳性表达率也明显高于未进展者,提示P16和Ki-67蛋白对预测早期宫颈癌发生具有重要价值。
Objective To explore the positive expressions of P16 and Ki-67 proteins in cervical biopsy lesions of patients with high-risk HPV infection and abnormal detection of liquid-based thin-layer cytology test(TCT),and the clinical value in predicting occurrence of early cervical cancer.Methods A total of 120 patients with high-risk HPV infection(16 and 18 subtypes positive)and abnormal TCT in the Traditional Chinese Medicine Hospital of Linhai from January 2016 to July 2017 were enrolled in the study.The colposcopy was used to get cervical biopsy lesions for pathological diagnosis,immunohistochemical staining was used to detect P16 and Ki-67 proteins.Results There were up to 66 patients with HPV-16 positive,34 cases with HPV-18 positive,other 20 cases with 16 and 18 positive;6 cases of atypical squamous epithelial cells(ASC),46 cases of low-grade squamous intraepithelial lesions(LSIL),60 cases of high-grade SIL(HSIL),other 8 cases of cervical squamous cell carcinoma(SCC)were diagnosed by TCT;5 cases of inflammation,105 cases of CIN and 10 cases of SCC by pathologically diagnosis.The positive rates of P16 and Ki-67 proteins were gradually increased in patients with inflammation,CIN and SCC[0(0/5),36.2%(38/105),70.0%(7/10),χ^2=4.382,P=0.036;0(0/5),40.0%(42/105),80.0%(8/10),χ^2=5.945,P=0.015].The patients with CIN were followed up for 21~36 months,median time 29.5 months.Twenty-six patients progressed to SCC,at the end of follow-up,the positive rates of P16 and Ki-67 proteins in patients with SCC were significantly higher than those in the CIN patients without progress[61.5%(16/26)vs.39.2%(31/79),χ^2=3.934,P=0.047;69.2%(18/26)vs.41.8%(33/79),χ^2=5.905,P=0.015].Conclusion The positive expression rates of P16 and Ki-67 proteins in cervical biopsy tissues are significantly higher in patients with high-risk HPV infection and abnormal TCT,which in patients with pathologically diagnosis of SCC are higher than CIN patients,the same results in CIN patients with SCC progression than non-progressing patients,suggesting that P1
作者
童卫青
徐海苗
Tong Weiqing;Xu Haimiao(Department of Pathology,the Traditional Chinese Medicine Hospital of Linhai,Linhai,Zhejiang 317000,China;Department of Pathology,Cancer Hospital Affiliated to the University of Chinese Academy of Sciences,Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang 310006,China)
出处
《中国基层医药》
CAS
2020年第2期163-167,共5页
Chinese Journal of Primary Medicine and Pharmacy
