目的 评估p16及Ki-67检测在子宫颈（以下简称宫颈）上皮内病变诊断中的价值,为临床应用提供依据。方法 选取2015年1月至2016年6月间我院收治的200例宫颈上皮病变患者的活检组织蜡块切片,进行适当的抗原修复后,使用免疫组织化学法检测病灶组织中p16及Ki-67的水平,分析p16、Ki-67检测在宫颈上皮内病变临床诊断中的价值。结果 p16及Ki-67在宫颈鳞状上皮内病变（squamous intraepithelial lesion,SIL）中的阳性表达率（88.00%、18.67%）明显高于萎缩性宫颈（10.00%及15.00%）、鳞状上皮化生（16.67%及16.67%）,差异有统计学意义（P<0.05）;而高度鳞状上皮内病变（high-grade squamous intraepithelial lesion,HSIL）中的p16及Ki-67阳性表达率（92.00%及93.00%）显著高于低度鳞状上皮内病变（low-grade squamous intraepithelial lesion, LSIL）病灶组织（80.00%、82.00%）（P<0.05）。在宫颈上皮内病变组织中,p16与Ki-67表达间的一致性良好,且具有统计学意义（P<0.05）; HSIL中的p16及Ki-67阳性细胞延至上皮下2/3 层及全层,其阳性表达明显高于LSIL,差异有统计学意义（P<0.05）。结论 p16、Ki-67含量检测可作为评价宫颈上皮内病变的重要指标,具有较高的临床诊断价值。
Objective: To assess the value of detection of p16 and Ki-67 in diagnosis of cervical intraepithelial lesions for providing a basis for its clinical application. Methods: Two hundred cases of cervical intraepithelial lesion selec-ted from January 2015 to June 2016 were served as the object of this study. The biopsy paraffin sections after appropriate antigen retrieval were used for detection of p16 and Ki-67 immunohistochemically and the value of detection of p16 and Ki-67 in diagnosis of cervical intraepithelial lesion was analyzed. Results: The positive expression rates of p16 and Ki-67 in cervical squamous intraepithelial lesion (SIL) were significantly higher than those in atrophic cervix and cervical squamous epithelial metaplasia (P< 0.05). The positive expression rates of p16 and Ki-67 in high grade squamous intraepithelial lesion (HSIL) were significantly higher than those in low grade squamous intraepithelial lesion (LSIL) (P< 0.05). In cervical intraepithelial lesion, the expressions of p16 and Ki-67 were in good consistency, and was statistically significant (P< 0.05). The p16, Ki67 positive cells extended to 2/3 layer or whole layer in HSIL, and the positive expression rate was significantly higher than that in LSIL (P< 0.05). Conclusions: Detection of p16 and Ki-67 can be used as an important indicator for cervical intraepithelial lesion and has high diagnostic value clinically.
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