目的探讨p16、Ki-67联合应用在宫颈上皮内瘤变(CIN)诊断及分级中的意义及人乳头状瘤病毒(HPV)感染与CIN的关系。方法分别对160例宫颈各类病变采用免疫组化方法检测p16、Ki-67蛋白表达情况,并行人乳头状瘤病毒分型检测。结果①宫颈上皮内低度瘤变(CINⅠ)中,p16阳性率为85.7%,Ki-67阳性率为67.8%,较宫颈良性病变的阳性率明显增加(P<0.01);宫颈上皮内高度瘤变(CINⅡ-Ⅲ)中,p16阳性率为100%,Ki-67阳性率为98.3%,两者相比差异极显著(P<0.01)。在CINⅡ-Ⅲ中,p16、Ki-67表达呈正相关。②高危型HPV在宫颈良性病变、CINⅠ和CINⅡ-Ⅲ病变组感染者分别为30.6%、75.7%和93.3%,宫颈CINI和CINⅡ-Ⅲ明显高于良性病变组,差异极显著(P<0.01)。随着宫颈上皮内瘤变程度加重,HPV感染与p16表达呈正相关。结论p16、Ki-67联合应用可作为宫颈良性病变与CINⅠ以及CINⅠ与CINⅡ-Ⅲ鉴别的重要标记物;高危型HPV感染与宫颈上皮内瘤变密切相关,在高危人员筛查与判断预后上有重要意义。 Objective To investigate the significance of p16 and Ki-67 in the diagnosis and classification of cervical intraepithelial neoplasia (CIN) and the relationship between HPV infection and CIN. Methods Immunohistochemical method was used to detect the expression of p16 and Ki-67 protein in 160 cases of cervical lesions. The HPV types were also detected. Results ① The positive rate of p16 was 85.7% and the positive rate of Ki-67 was 67.8% in cervical intraepithelial neoplasia (CINⅠ), which was significantly higher than that of benign cervical lesions (P <0.01). The positive rate of cervical intraepithelial neoplasia In CINⅡ-Ⅲ, the positive rate of p16 was 100% and the positive rate of Ki-67 was 98.3%. There was significant difference between the two groups (P <0.01). In CINⅡ-Ⅲ, p16, Ki-67 expression was positively correlated. (2) The risk of high-risk HPV was significantly higher in benign cervical lesions than that in benign lesions (P <0.01). The positive rates of CINI and CINⅡ-Ⅲ in cervical CINⅠ and CINⅡ-Ⅲ were 30.6%, 75.7% and 93.3% . As the degree of cervical intraepithelial neoplasia increased, HPV infection was positively correlated with p16 expression. Conclusion The combination of p16 and Ki-67 can be used as an important marker of cervical benign lesions and CIN Ⅰ and CIN Ⅰ and CIN Ⅱ-Ⅲ identification; high-risk HPV infection and cervical intraepithelial neoplasia are closely related to high-risk screening and prognosis Significance.