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目的研究p16、Rb、Ki-67在宫颈上皮内瘤变(CIN)中的表达,探讨其与HPV感染的关系。方法对121例CIN病变上皮和36例正常上皮行免疫组化染色检测p16、Rb及Ki-67表达情况,其中47例CIN病例用原位杂交法检测高危型HPV感染情况。结果与对照组相比p16、Ki-67在各级别CIN中均有较高表达(P<0.01),且CIN2和CIN3中的表达较CIN1高(P<0.05);同时二者阳性表达均见分层现象。Rb蛋白的阳性率及表达强度从CIN1到CIN3逐渐下调(分别为54.2%、24.4%、21.9%),在对照组与各级别CIN之间差异均有显著性(P<0.01),但CIN2与CIN3之间无差别。CIN1、CIN2及CIN3患者高危型HPV阳性率分别为(71.9%)、(85.3%)和(90.6%),随CIN级别的增加而升高,与对照组相比差异有统计学意义(P<0.01),但不同级别CIN之间差别无统计学意义。结论高危型HPV感染及p16、Ki-67及Rb与宫颈癌前病变发生机制及病变进展相关,联合检测p16蛋白和Ki-67、Rb抗原表达可作为CIN分级诊断的辅助方法。
Objective To study the expression of p16, Rb and Ki-67 in cervical intraepithelial neoplasia (CIN) and to explore their relationship with HPV infection. Methods The expressions of p16, Rb and Ki-67 in 121 cases of CIN epithelial cells and 36 cases of normal epithelium were detected by immunohistochemistry. 47 cases of CIN cases were detected by in situ hybridization. Results Compared with the control group, the expression of p16 and Ki-67 was significantly higher in CIN (P <0.01), and higher in CIN2 and CIN3 than in CIN1 (P <0.05) Stratification. The positive rate and expression intensity of Rb protein were gradually decreased from CIN1 to CIN3 (54.2%, 24.4% and 21.9% respectively), and there was significant difference between CIN and control group (P <0.01) There is no difference between CIN3. The positive rates of high-risk HPV in patients with CIN1, CIN2 and CIN3 were 71.9%, 85.3% and 90.6%, respectively, which were increased with the increase of CIN level, and the difference was statistically significant compared with the control group (P < 0.01), but the difference between different levels of CIN was not statistically significant. Conclusions High-risk HPV infection, p16, Ki-67 and Rb are associated with the pathogenesis and progression of cervical precancerous lesions. Combined detection of p16 protein, Ki-67 and Rb antigen expression can be used as an adjunct to CIN grading.