外阴上皮内瘤变组织中P16和Ki-67的表达及其意义(1)
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[摘要] 目的:探讨P16和Ki-67在外阴上皮内瘤变(VIN)组织中的表达及其意义。方法:采用免疫组化SP法检测44例VIN(VINⅠ16例,VINⅡ、Ⅲ 28例)组织中P16和Ki-67的原位表达,并以30例正常外阴组织作为对照。结果:对照组、低级别VIN(VINⅠ)和高级别VIN(VINⅡ、Ⅲ)组织中P16的阳性率依次为7%、44%和100%,Ki-67的阳性率依次为10%、75%和100%;P16和Ki-67在VINⅡ、Ⅲ和对照组,VINⅡ、Ⅲ和VINⅠ之间的阳性表达率差异均具有统计学意义(P<0.01)。若将P16阳性表达界定为中和(或)上1/3外阴上皮细胞弥漫阳性着色、Ki-67阳性界定为下1/3外阴上皮以上大于或等于25%的上皮细胞胞核阳性着色,作为鉴别高级别VIN的标志物,P16的敏感性、特异性分别为93%、93%,Ki-67的敏感性、特异性分别为96%、85%。结论:P16和Ki-67在对照组、低级别VIN与高级别VIN组织中的表达有显著差异,可较敏感地鉴别出高级别VIN。采用二者联合标记,更能有效地降低假阳性病例的干扰,提高VIN诊断的特异性。
[关键词] 外阴上皮内瘤变; P16; Ki-67; 免疫组织化学; 表达
[中图分类号] R711.72; Q786 [文献标识码] A [文章编号] 1671-7562(2011)01-0028-05
doi:10.3969/j.issn.1671-7562.2011.01.008
[收稿日期] 2010-05-19 [修回日期] 2010-09-29
[作者简介] 王文忠(1975-),男,湖南湘乡人,主治医师。E-mail: wwzbl502@163.com
Expression and significance of P16 and Ki-67 in differential diagnosis
of high-grade and non-high-grade vulvar intraepithelial neoplasia
WANG Wen-zhong1, LI Dai-qiang2
(1. Department of Pathology, the People's Hospital of Xiangxiang, Xiangxiang 411400, China; 2. Department of
Pathology, Xiangya Second Hospital of Zhongnan University, Changsha 410011, China)
[Abstract] Objective: To investigate the effects of P16 and Ki-67 on vulvar intraepithelial neoplasia(VIN). Methods: The expression of P16 and Ki-67 in situ in the lesion of 44 patients[16 low-grade VIN(VIN Ⅰ), and 28 high-grade VIN(VINⅡand Ⅲ)] were examined by immunohistochemical assay;and 30 normal vulvar tissues were treated as controls. Results: The positive percentages of P16 in normal vulvar tissues, VIN Ⅰ,Ⅱ, Ⅲ were 7%,44%,100% respectively; The positive percentages of Ki-67 in normal vulvar tissues, VIN Ⅰ,Ⅱ, Ⅲ were 10%,75%,100% respectively. The expressions of P16 and Ki-67 had significant differences between the high grade and low grade VIN(P<0.01). When positive P16 staining was defined as the presence of diffuse/continuous staining in more than one-third of the thickness of epithelium, the sensitivity and specificity of P16 as a marker for diagnosing high-grade VIN were 93%, 93%, When positive Ki-67 staining was defined as the presence of nuclear staining in more than 25% of the cells in more than one-third of the thickness of epithelium, the sensitivity and specificity of Ki-67 as a marker for diagnosing high-grade VIN were 96%, 85% ......
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