不同级别宫颈鳞状上皮内病变中Ki67指数与P16表达的比较。

Comparison of Ki67 index and P16 expression in different grades of cervical squamous intraepithelial lesions.

作者信息

Hosseini Maryam Sadat, Talayeh Maryam, Afshar Moghaddam Noushin, Arab Maliheh, Farzaneh Farah, Ashrafganjoei Tahereh

机构信息

Preventative Gynecology Research Center, Department of Obstetrics and Gynecology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Gynaeco-oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical, Tehran, Iran.

出版信息

Caspian J Intern Med. 2023 Winter;14(1):69-75. doi: 10.22088/cjim.14.1.69.

DOI:10.22088/cjim.14.1.69

PMID:36741489

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9878899/

Abstract

BACKGROUND

the assessment of P16 expression and Ki-67 proliferative index is now proposed as an adjunct test for the diagnosis of high-risk precursor lesions for cervical cancer. The aim of the present study was to elucidate the quality expression of P16 and quantification Ki-67 index in different types of cervical intraepithelial neoplasia and also to determine the cutoff for Ki67 index to predict the severity of CIN lesions.

METHODS

This cross-sectional study was conducted on patients with colposcopic indication. Selected samples with different CIN grades were examined for P16 and Ki-67 index by immunohistochemical (IHC) methods.

RESULTS

All LSIL (CIN I) cases were negative for P16, while in 58.7% of HSIL cases (CIN 2/3), P16 was positive. The mean Ki67 index in the present study was 3.13 ± 2.65 in the upper two/third of the squamous epithelium in the LSIL group and 19.04 ±36.40 in the HSIL group, which was statistically significant. Also, the mean Ki67 index in full thickness squamous epithelium in HSIL group was significantly higher than LSIL. The sensitivity of P16 and Ki67 index in our study was 58.73%, 66.67% and the specificity was 100% and 100%, respectively.

CONCLUSION

Assessment of P16 expression and Ki67 index can be used to distinguish low grade (CIN1) intraepithelial lesion from high grade (CIN2/3) intraepithelial or precancerous lesions.

摘要

背景

目前建议评估P16表达和Ki-67增殖指数作为宫颈癌高危前体病变诊断的辅助检查。本研究的目的是阐明不同类型宫颈上皮内瘤变中P16的质量表达和Ki-67指数的定量，同时确定Ki67指数的临界值以预测CIN病变的严重程度。

方法

本横断面研究针对有阴道镜检查指征的患者进行。通过免疫组织化学（IHC）方法对选定的不同CIN级别的样本进行P16和Ki-67指数检测。

结果

所有低级别鳞状上皮内病变（CIN I）病例的P16均为阴性，而在58.7%的高级别鳞状上皮内病变（CIN 2/3）病例中，P16为阳性。在本研究中，低级别鳞状上皮内病变组鳞状上皮上2/3的平均Ki67指数为3.13±2.65，高级别鳞状上皮内病变组为19.04±36.40，差异有统计学意义。此外，高级别鳞状上皮内病变组全层鳞状上皮的平均Ki67指数明显高于低级别鳞状上皮内病变组。本研究中P16和Ki67指数的敏感性分别为58.73%、66.67%，特异性均为100%。