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Ki67 在 LSIL 诊断中的价值及 p16 在 HSIL 诊断中的问题。

The value of Ki67 for the diagnosis of LSIL and the problems of p16 in the diagnosis of HSIL.

机构信息

Department of Pathology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China.

出版信息

Sci Rep. 2022 May 9;12(1):7613. doi: 10.1038/s41598-022-11584-z.

Abstract

p16 and Ki67 are immunohistochemical markers related to cervical squamous intraepithelial lesions. p16 has been widely used to assist in the diagnosis of high-grade squamous intraepithelial lesions. However, a conclusion about the role of Ki67 in the diagnosis of squamous intraepithelial lesions has not been established. The aim of this study was to analyze the role of p16 and Ki67 immunohistochemical staining in assisting cervical squamous intraepithelial lesions. This study performed immunohistochemical staining for p16 and Ki67 on 1024 cervical biopsy specimens at our hospital to compare the differences between p16 and Ki67 in different cervical lesions using the chi-squared test and Fisher's exact test. This study also evaluated the value of Ki67 for the diagnosis of low-grade squamous intraepithelial lesions (LSILs) using the receiver operating characteristic curve. The results indicated that Ki67 had high specificity and sensitivity in distinguishing LSIL from normal cervix. p16 was diffusely and strongly positive in some LSILs, and some problems were encountered in the interpretation of p16 staining. Therefore, we believe that Ki67 can be used as an immunohistochemical marker to help in the diagnosis of LSIL, to distinguish lesions that are difficult to morphologically determine and to avoid misdiagnosis. The practical application of p16 staining is still problematic. It may be necessary to find other auxiliary means to distinguish this small proportion of cervical lesions.

摘要

p16 和 Ki67 是与宫颈鳞状上皮内病变相关的免疫组织化学标志物。p16 已广泛用于协助诊断高级别鳞状上皮内病变。然而,Ki67 在鳞状上皮内病变诊断中的作用尚未得到确定。本研究旨在分析 p16 和 Ki67 免疫组织化学染色在协助宫颈鳞状上皮内病变中的作用。本研究对我院 1024 例宫颈活检标本进行了 p16 和 Ki67 的免疫组织化学染色,采用卡方检验和 Fisher 确切检验比较了 p16 和 Ki67 在不同宫颈病变中的差异。本研究还通过受试者工作特征曲线评估了 Ki67 对诊断低级别鳞状上皮内病变(LSIL)的价值。结果表明,Ki67 在区分 LSIL 与正常宫颈方面具有较高的特异性和敏感性。一些 LSIL 中 p16 弥漫性强阳性,p16 染色的解释存在一些问题。因此,我们认为 Ki67 可以作为一种免疫组织化学标志物,有助于 LSIL 的诊断,区分形态学难以确定的病变,并避免误诊。p16 染色的实际应用仍存在问题。可能需要寻找其他辅助手段来区分这一小部分宫颈病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/066f/9085733/280cc6416e93/41598_2022_11584_Fig1_HTML.jpg

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