年轻女性宫颈CINⅠⅡ级病变中p16InK4a与Ki67临床意义.docVIP

年轻女性宫颈CINⅠⅡ级病变中p16InK4a与Ki67临床意义 　　【摘要】目的：探讨年轻女性宫颈CINI/II级病变组织p16InK4a及Ki67在预测病变转归中的作用与意义。方法：选取2010年在北大医院妇产科门诊就诊、年龄小于35岁、经阴道镜活检病理诊断为CINⅠ及CINⅡ级的病例56例，对其阴道活检组织之石蜡切片，进行p16InK4a及Ki67免疫组织化学染色。并对病例进行随访。结果：（1）阴道镜活检组织的CINI及CINII中p16InK4a阳性表达率分别为30.0%、80.6%，Ki67阳性率分别为20.0%、77.8%；（2）在高危HPV持续感染病例组的p16InK4a及Ki67阳性率低于未持续感染病例组，差异有统计学意义（p16InK4a：25.0%和69.0%，P=0.041；Ki67：12.5%和64.3%，P=0.015）；（3）活检组织p16InK4a及Ki67的阳性率在随访一年CIN进展/未进展组中未见显著差异（p16InK4a： P=0.106；Ki67： P=0.173）。结论：p16InK4a及Ki67对CIN进展及HR-HPV持续感染的预测提示作用有待进一步研究证实。 　　【关键词】p16InK4a；Ki67；年轻女性；宫颈上皮内瘤变 　　Expression of p16InK4a and Ki67 and their significance in predicting progression of cervical intraepithelial neoplasia Ⅰ～Ⅱ in young womenLI Siqi1， DONG Ying2， BI Hui1△， ZHANG Xiaoming2， CHEN Rui1. 1. Department of Gynaecology and Obstetrics， Peking University First Hospital， Beijing 100034， China； 2. Department of Pathology， Peking University First Hospital， Beijing 100034， China 　　【Abstract】Objectives： This study aims to detect the expression of p16InK4a and ki67 in CIN I～II in young women， and to evaluate their value in predicting progression and HR-HPV （high risk human papilloma virus） persistence. Methods： Fifty-six women （≤35 y） with a histological diagnosis of CINI～II， who attended a colposcopy with cone biopsy in Peking University First Hospital Obstetrics and Gynecology Out-patient Department in 2010， were included in this study. P16InK4a and ki67 immunohistochemical staining were performed on all tissues. Follow-up was conducted. Results： i. In punch biopsy tissues： expression rate of p16INK4a in CINI and CINII were 30.0% and 80.6% respectively， with a significant difference （P0.001）； expression rate of Ki67 in CINI and CINⅡ were 20.0% and 77.8% respectively， with a significant difference （P0.001）. ii. The expression rate of both p16INK4a and ki67 in punch biopsy tissues was lower in group with HR-HPV persistence than the other group. （p16InK4a： 25.0% vs 69.0%， P=0.041；Ki67： 12.5% vs 64.3%， P=0.015）. iii. The express