外阴上皮内瘤变组织中P16和Ki67表达及其意义.docVIP

外阴上皮内瘤变组织中P16和Ki67表达及其意义 　　[摘要] 目的:探讨P16和Ki-67在外阴上皮内瘤变（VIN）组织中的表达及其意义。方法：采用免疫组化SP法检测44例VIN（VINⅠ16例，VINⅡ、Ⅲ 28例）组织中P16和Ki-67的原位表达，并以30例正常外阴组织作为对照。结果：对照组、低级别VIN（VINⅠ）和高级别VIN（VINⅡ、Ⅲ）组织中P16的阳性率依次为7%、44%和100%，Ki-67的阳性率依次为10%、75%和100%；P16和Ki-67在VINⅡ、Ⅲ和对照组，VINⅡ、Ⅲ和VINⅠ之间的阳性表达率差异均具有统计学意义（P＜0.01）。若将P16阳性表达界定为中和（或）上1/3外阴上皮细胞弥漫阳性着色、Ki-67阳性界定为下1/3外阴上皮以上大于或等于25%的上皮细胞胞核阳性着色，作为鉴别高级别VIN的标志物，P16的敏感性、特异性分别为93%、93%，Ki-67的敏感性、特异性分别为96%、85%。结论：P16和Ki-67在对照组、低级别VIN与高级别VIN组织中的表达有显著差异，可较敏感地鉴别出高级别VIN。采用二者联合标记，更能有效地降低假阳性病例的干扰，提高VIN诊断的特异性。 　　［关键词］ 外阴上皮内瘤变； P16； Ki-67； 免疫组织化学； 表达 　　［中图分类号］ R711.72; Q786 ［文献标识码］ A ［文章编号］ 1671-7562（2011）01-0028-05 　　doi:10.3969/j.issn.1671-7562.2011.01.省略 　　Expression and significance of P16 and Ki-67 in differential diagnosis 　　of high-grade and non-high-grade vulvar intraepithelial neoplasia 　　WANG Wen-zhong1， LI Dai-qiang2 　　（1. Department of Pathology, the Peoples Hospital of Xiangxiang, Xiangxiang 411400, China； 2. Department of 　　Pathology, Xiangya Second Hospital of Zhongnan University, Changsha 410011, China） 　　[Abstract] Objective: To investigate the effects of P16 and Ki-67 on vulvar intraepithelial neoplasia（VIN）. Methods: The expression of P16 and Ki-67 in situ in the lesion of 44 patients［16 low-grade VIN（VIN Ⅰ）, and 28 high-grade VIN（VINⅡand Ⅲ）］ were examined by immunohistochemical assay；and 30 normal vulvar tissues were treated as controls. Results: The positive percentages of P16 in normal vulvar tissues, VIN Ⅰ,Ⅱ, Ⅲ were 7%,44%,100% respectively; The positive percentages of Ki-67 in normal vulvar tissues, VIN Ⅰ,Ⅱ, Ⅲ were 10%，75%，100% respectively. The expressions of P16 and Ki-67 had significant differences between the high grade and low grade VIN（P＜0.01）. When positive P16 staining was defined as the presence of diffuse/continuous staining in more than one-third of the thickness of epithelium, the sensitivity and specificity of P16 as a marker for diagnosing high-grade VIN were 93%, 93%, When positive Ki-67 staining was defined as the p