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目的研究p16INK4a联合CK17在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)中的表达情况,探索其临床意义。方法以导流杂交技术检测宫颈病变中高危型人乳头瘤病毒(high risk human papilloma virus,HRHPV)感染,用免疫组织化学方法分别检查CIN病变组织中p16INK4a和CK17表达,并分析HR-HPV病毒感染与p16INK4a及CK17的关联性。结果 1根据宫颈病理结果,将本组119例患者分为3组,其中A组43例,包括慢性宫颈炎及CINⅠ;B组71例,包括CINⅡ-Ⅲ;C组5例,包括宫颈癌。在A组中,HR-HPV感染率为51.2%(22/43),B组中,HR-HPV感染率为86.0%(61/71),在C组中,HR-HPV感染率为100%(5/5);2p16INK4a在宫颈炎、CIN、宫颈癌组织中的表达率分别为14.0%、63.8%、100%,表达率逐渐增高;而CK17分别为58.1%、22.5%、0%表达率逐渐降低。差异均有统计学意义(χ2=32.13,P<0.05;χ2=17.78,P<0.05)。3宫颈病变中,p16INK4a与CK17无相关性;p16INK4a的表达与HR-HPV病毒含量正相关(r=0.291,P=0.001),而CK17表达与HPV病毒含量负相关(r=-0.335,P<0.001)。结论p16INK4a与CK17的联合检测在宫颈病变的诊断中无明显意义,但均与HR-HPV感染相关的CIN的发生发展密切关系。
Objective To investigate the expression of p16INK4a combined with CK17 in cervical intraepithelial neoplasia (CIN) and to explore its clinical significance. Methods High-risk human papilloma virus (HRHPV) infection in cervical lesions was detected by flow-through hybridization. The expression of p16INK4a and CK17 in CIN lesions was detected by immunohistochemistry. The HR-HPV infection Correlation with p16INK4a and CK17. Results 1 According to the results of cervical pathology, 119 patients in this group were divided into 3 groups, including 43 cases in group A, including chronic cervicitis and CINⅠ; 71 cases in group B, including CINⅡ-Ⅲ; and 5 cases in group C, including cervical cancer. In group A, HR-HPV infection rate was 51.2% (22/43), HR-HPV infection rate was 86.0% (61/71) in group B, HR-HPV infection rate was 100% (5/5). The expression rates of 2p16INK4a in cervicitis, CIN and cervical cancer were 14.0%, 63.8% and 100%, respectively, while the expression rates of CK17 were 58.1%, 22.5% and 0% Gradually decreases. The differences were statistically significant (χ2 = 32.13, P <0.05; χ2 = 17.78, P <0.05). The expression of p16INK4a was positively correlated with the content of HR-HPV (r = 0.291, P = 0.001), while the expression of CK17 was negatively correlated with the content of HPV (r = -0.335, P < 0.001). Conclusion The combined detection of p16INK4a and CK17 has no obvious significance in the diagnosis of cervical lesions, but both are closely related to the occurrence and development of CIN associated with HR-HPV infection.