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目的研究p16、Ki-67在不同宫颈病变组织中的表达,探讨其在病理诊断中的意义。方法采用免疫组化SP方法检测宫颈病变组织中p16、Ki-67的表达水平,其中宫颈良性反应性改变193例(老年宫颈萎缩性改变35例,宫颈鳞状上皮化性77例,宫颈鳞状上皮良性增生81例),宫颈上皮内瘤变(CIN)227例(CINⅠ86例,CINⅡ88例,CINⅢ53例),宫颈鳞状细胞癌16例及宫颈腺上皮病变7例(其中3例来源于CIN组)共计440例。结果宫颈良性反应性改变组p16、Ki-67的阳性率明显低于CIN组及宫颈鳞状细胞癌组(P<0.01);在CIN组中阳性强度随着CIN病变级别的增加而增强(P<0.01);在宫颈鳞状细胞癌病例组中呈强阳性;宫颈腺上皮不典型增生的p16、Ki-67也呈不同程度(+)。结论 p16、Ki-67对宫颈良性改变的甄别、CIN级别的判定及宫颈早期浸润癌的诊断具有重要价值。
Objective To study the expression of p16 and Ki-67 in different cervical lesions and to explore its significance in the pathological diagnosis. Methods Immunohistochemical SP method was used to detect the expression of p16 and Ki-67 in cervical lesions, including 193 cases of benign cervical changes (35 cases of cervical atrophy, 77 cases of cervical squamous cell carcinoma, 81 cases of benign epithelial hyperplasia, 227 cases of cervical intraepithelial neoplasia (CINⅠ86 cases, CINⅡ88 cases and CINⅢ53 cases), cervical squamous cell carcinoma (16 cases) and cervical glandular epithelial disease (7 cases) (3 cases were from CIN group A total of 440 cases. Results The positive rate of p16 and Ki-67 in cervical benign reaction group was significantly lower than that in CIN group and cervical squamous cell carcinoma group (P <0.01). In CIN group, the positive rate of P16 and Ki-67 increased with the increase of CIN level (P <0.01). In cervical squamous cell carcinoma cases, the expression of p16 and Ki-67 were strongly positive (+). Conclusion The detection of p16 and Ki-67 in cervical benign changes, the determination of CIN grade and the diagnosis of early invasive carcinoma of the cervix are of great value.