Gynenova Policlinic, Istarska 21, 21000 Split, Croatia.
Int J Gynecol Cancer. 2010 Jan;20(1):116-9. doi: 10.1111/IGC.0b013e3181bc8da7.
To assess the value of Ki-67 quantitative analysis in cervical intraepithelial neoplasia (CIN) in relation to CIN grading and human papillomavirus (HPV) group typing.
Cervical samples selected retrospectively from 106 cases were analyzed immunohistochemically for Ki-67-positive nuclei in 3 epithelial layers and by polymerase chain reaction for HPV typing.
The proportion of high-risk HPV positivity was 0% in normal controls and 30% in CIN 1, 57% in CIN 2, and 90% in CIN 3 groups, and there was no low-risk HPV finding in CIN 2 and CIN 3 cases (P < 0.001). High-risk HPV-positive cases exhibited significantly more Ki-67-positive nuclei per 100-mum basal membrane, which were more frequent in the middle and upper third layers of the epithelium compared with low-risk HPV and HPV-negative cases (P < 0.001). The differences among the CIN groups in the total number and in the percentages of Ki-67-positive nuclei in the lower, middle, and upper third layers of the epithelium were significant (P < 0.001). With the cutoff value of more than 33% Ki-67-positive nuclei in the middle and the upper third layers of the epithelium, Ki-67 staining demonstrated 98.4% sensitivity (60/61 cases) and 97.8% specificity (44/45 cases) for the detection of CIN 2/CIN 3 in our study group.
The Ki-67 immunostaining proved to be predictive for high-risk HPV infection, and it can differentiate reactive lesions from cervical dysplasias. Ki-67 quantitative analysis in 3 epithelial layers is a sensitive and specific method of differentiation between CIN 1 and CIN 2/CIN 3 grades and can be a valuable adjunctive method for more accurate CIN grading.
评估 Ki-67 定量分析在宫颈上皮内瘤变（CIN）中的价值，与 CIN 分级和人乳头瘤病毒（HPV）分型相关。
回顾性选择 106 例宫颈标本，对 3 个上皮层的 Ki-67 阳性核进行免疫组织化学分析，并通过聚合酶链反应进行 HPV 分型。
正常对照组 HPV 高危型阳性率为 0%，CIN 1 组为 30%，CIN 2 组为 57%，CIN 3 组为 90%，CIN 2 和 CIN 3 组均未发现低危型 HPV（P<0.001）。高危型 HPV 阳性病例的每 100μm 基底膜 Ki-67 阳性核数量明显更多，且在上皮的中、上层更为频繁，与低危型 HPV 和 HPV 阴性病例相比差异有统计学意义（P<0.001）。CIN 组中，上皮下、中、上层 Ki-67 阳性核总数和百分比差异有统计学意义（P<0.001）。以中、上层 Ki-67 阳性核比例>33%作为截断值，Ki-67 染色对本研究组中 CIN 2/CIN 3 的检测敏感性为 98.4%（60/61 例），特异性为 97.8%（44/45 例）。
Ki-67 免疫染色可预测高危型 HPV 感染，能区分反应性病变与宫颈发育不良。3 个上皮层的 Ki-67 定量分析是区分 CIN 1 与 CIN 2/CIN 3 分级的一种敏感且特异的方法，是一种更准确的 CIN 分级的有价值的辅助方法。
