Kanthiya Kanjana, Khunnarong Jakkapan, Tangjitgamol Siriwan, Puripat Napaporn, Tanvanich Sujitra
Department of Obstetrics and Gynecology, Department of Anatomical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand Email :
Asian Pac J Cancer Prev. 2016;17(7):3201-6.
To evaluate the expression of p16 and Ki67 in cervical intraepithelial neoplasia (CIN) and cancer.
We performed a immunohistochemical study of p16 and Ki67 in 243 cervical tissues 53 nondysplastic lesions, 106 CIN1, 61 CIN2/3 and 23 squamous cell carcinomas. The expression of p16 and Ki67 was interpreted independently by 2 researchers and the sensitivity and specificity to detect clinically significant lesions (≥ CIN2) were determined.
The overall agreement results of positive or negative immunostaining of intrainter observer variability were 0.659 for p16 and 0.808 for Ki67. p16 expression was demonstrated in 91.3% of invasive carcinomas, 78.7% of CIN2/3, 10.4% of CIN1 and 9.4% of nondysplasic lesions. The corresponding Ki67 expression was: 100% of all invasive carcinomas, 75.4% of CIN2/3, 22.6% of CIN1, and 11.3% with nondysplasia. The expression was significantly different between CIN2/3 vs CIN1 for both p16 and Ki67 (pvalues <0.001 both), and cancer vs CIN2/3 for Ki67 (pvalue 0.008). The differences were not significant between CIN1 vs nondysplasia (pvalues 1.000 for p16 and 0.130 of Ki67), and cancer vs CIN2/3 for p16 (p value 0.219). The sensitivity and specificity to detect > CIN2 were 84.5% and 90.5% by p16 and 82.1% and 88.6% by Ki67.
The rates for 16 and Ki67 expression were directly associated with the severity of cervical lesions. Significant differences in these markers expression may be useful in cases with equivocal histologic features among cervical intraepithelial lesions, but not between CIN1 and nondysplastic lesions. The two markers had high sensitivity and specificity in determining >CIN2.
评估p16和Ki67在宫颈上皮内瘤变（CIN）及宫颈癌中的表达情况。
我们对243例宫颈组织进行了p16和Ki67的免疫组化研究，其中包括53例非发育异常病变、106例CIN1、61例CIN2/3和23例鳞状细胞癌。由两名研究人员独立解读p16和Ki67的表达情况，并确定检测具有临床意义病变（≥CIN2）的敏感性和特异性。
观察者间免疫染色阳性或阴性的总体一致性结果，p16为0.659，Ki67为0.808。p16表达在91.3%的浸润癌、78.7%的CIN2/3、10.4%的CIN1和9.4%的非发育异常病变中得以证实。相应的Ki67表达情况为：所有浸润癌为100%，CIN2/3为75.4%，CIN1为22.6%，非发育异常为11.3%。对于p16和Ki67，CIN2/3与CIN1之间的表达存在显著差异（两者p值均<0.001），对于Ki67，癌与CIN2/3之间存在显著差异（p值0.008）。CIN1与非发育异常之间（p16的p值为1.000，Ki67的p值为0.130）以及癌与CIN2/3之间对于p16（p值0.219）的差异均不显著。p16检测>CIN2的敏感性和特异性分别为84.5%和90.5%，Ki检测>CIN2的敏感性和特异性分别为82.1%和88.
