宫颈高度鳞状上皮内病变中p16、Ki67表达强度与人乳头瘤病毒-DNA病毒载量的相关性分析

摘要

Objective To investigate the correlation between the expression intensity of p 16 and Ki 67 and human papilloma virus(HPV)-DNA viral load in high -grade cervical squamous intraepithelial lesions (HSIL).Methods p 16 and Ki 67 were detected by immunohistochemistry in 83 patients with HSIL confirmed by pathologically and further underwent loop electrosurgical excision procedure (LEEP) in Boai Hospital of Zhongshan City from January 2014 to August 2017, and the HPV -DNA viral load before biopsy (HC2) was analyzed retrospectively.Results HPV-DNA was positive in 83 cases, with low, medium and high viral load of 11 cases (13.3 %), 24 cases (28.9 %), and 48 cases (57.8 %) respectively.In 83 cases of HSIL, p 16 negative, focal positive, diffuse positive were 17 cases (20.5 %), 37 cases (44.6 %), 29 cases (34.9 %) respectively, the positive rate was 79.5%(66/83).Ki 67 negative, low expression, high expression were 19 cases (22.9 %), 21 cases (25.3 %), 43 cases (51.8 %) respectively, the positive rate was 77.1%(64/83).The difference in HPV low, middle and high viral load between p 16 -negative, focal-positive and diffuse -positive groups was statistically significant in 83 HSIL patients(χ2＝16.916,P＝0.002), there was a positive correlation between the expression intensity of p 16 and HPV -DNA viral load(rs＝0.408,P＝0.000).The difference of HPV low, medium and high viral load in Ki 67-negative, low-expressing and high -expressing groups was statistically significant (χ2＝16.453, P＝0.002).Ki 67 expression intensity was positively correlated with HPV -DNA viral load (rs＝0.404,P＝0.000).Conclusion HPV load is related to the expression intensity of p 16 and Ki 67, the combination of the three will help to monitor the progress of HSIL and make better clinical management.%目的 探讨宫颈高度鳞状上皮内病变(high-grade squamous intraepithelial lesion ,HSIL)中p 16、Ki 67表达强度与人乳头瘤病毒(human papilloma virus ,HPV)-DNA病毒载量之间相关性.方法 用免疫组化法对2014年1月至2017年8月在中山市博爱医院妇科经病理确诊为HSIL并进一步行宫颈环形电切术的83例病例进行p 16、Ki 67检测,并回顾分析其活检前HPV-DNA病毒载量情况(HC2法).结果 所有病例HPV-DNA均为阳性,其中低、中、高病毒载量分别为11 例(13.3 %)、24 例(28.9 %)、48 例(57.8 %). 83例HSIL中p 16阴性、局灶阳性、弥漫阳性分别为17例(20.5 %)、37例(44.6 %)、29 例(34.9 %),阳性率为79.5%(66/83). Ki 67阴性、低表达、高表达分别为19例(22.9%)、21例(25.3%)、43例(51.8%),阳性率为77.1 %(64/83). 83例HSIL中p 16阴性、局灶阳性、弥漫阳性组中HPV低、中、高病毒载量间差异有统计学意义(χ2＝16.916,P＝0.002),p 16表达强度与HPV-DNA病毒载量之间呈正相关(rs＝0.408,P＝0.000).Ki 67阴性、低表达、高表达组中HPV低、中、高病毒载量间差异有统计学意义(χ2＝16.453,P＝0.002),Ki 67表达强度与HPV-DNA病毒载量之间呈正相关(rs＝0.404,P＝0.000).结论 HPV载量与p 16及Ki 67的表达强度具有相关性,三者结合有助于监测HSIL的进展,从而对其进行更好的临床管理.