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目的定量探讨Ki67和P53在子宫颈鳞状细胞癌(SCC)、宫颈上皮内瘤变(CIN)及慢性炎症中的表达特点、变化规律及其临床意义。方法用免疫组化和图像定量分析技术检测11例宫颈癌、27例宫颈上皮内瘤变(其中CINⅠ10例,CINⅡ6例,CINⅢ11例)及7例子宫颈慢性炎症(CC-itis)的石蜡标本中Ki67和P53表达的阳性单位。结果 Ki67和P53在SCC、CIN及CC-itis组织中表达的阳性单位(PU)差异具有显著性(F=26.447,F=9.564,P均<0.001),SCC、CIN病变中Ki67和P53表达的阳性单位明显高于CC-itis,差异具有显著性(P均<0.001)。CIN病变中Ki67的阳性单位具有随CIN分级增高而增大的趋势(单侧检验P<0.05)。CINⅢ组中Ki67表达的阳性单位明显高于CINⅠ组,差异有统计学意义(P=0.023);P53的阳性单位在CIN不同级别的比较中差异具有显著性(P=0.01),CINⅡ组中P53的阳性单位明显高于CINⅠ组,差异有统计学意义(P=0.003)。宫颈病变需手术组的Ki67和P53的阳性单位均明显高于保守治疗组,差异具有统计学意义(P均<0.001)。结论 Ki67和P53的表达强度与宫颈慢性炎症、宫颈上皮内瘤变及宫颈鳞状细胞癌有关,两者在组织中表达的阳性单位对于区分宫颈炎性病变和上皮内瘤变,区分低级别和高级别上皮内瘤变,包括CINⅠ和CINⅡ的区分,以及对于治疗方案的拟定均具有重要价值;此外Ki67表达的阳性单位有助于CIN分级。
Objective To investigate the expression, clinical significance and clinical significance of Ki67 and P53 in cervical squamous cell carcinoma (SCC), cervical intraepithelial neoplasia (CIN) and chronic inflammation. Methods The expression of Ki67 in 11 cases of cervical cancer, 27 cases of cervical intraepithelial neoplasia (including 10 cases of CINⅠ, 6 cases of CINⅡ, 11 cases of CINⅢ) and 7 cases of chronic cervicitis (CC-itis) were detected by immunohistochemistry and image quantitative analysis. And positive units of P53 expression. Results The positive expression rates of Ki67 and P53 in SCC, CIN and CC-itis tissues were significantly different (F = 26.447, F = 9.564, P <0.001). The expressions of Ki67 and P53 in SCC and CIN Positive units were significantly higher than CC-itis, the difference was significant (P <0.001). The positive units of Ki67 in CIN lesions tended to increase with the CIN grade (P <0.05 for one-sided test). The positive expression rate of Ki67 in CINⅢgroup was significantly higher than that in CINⅠgroup (P = 0.023). There was a significant difference in the positive units of P53 between different levels of CIN (P = 0.01) The positive unit was significantly higher than CIN Ⅰ group, the difference was statistically significant (P = 0.003). The positive units of Ki67 and P53 in the cervical lesions requiring operation were significantly higher than those in the conservative treatment group (P <0.001). Conclusions The expressions of Ki67 and P53 are correlated with chronic cervicitis, cervical intraepithelial neoplasia and cervical squamous cell carcinoma. The positive expression of Ki67 and P53 in the tissue differentiate between cervical inflammatory lesions and intraepithelial neoplasia, High-grade intraepithelial neoplasia, including the distinction between CIN I and CIN II, is of great value for the formulation of treatment regimens; in addition, positive units for Ki67 expression contribute to CIN classification.