Value Of P16,Ki67 And ΔNp63 In Improving The Diagnosis Of High-grade Cervical Intraepithelial Neoplasia

Objective :1.The P16,Ki67 and ΔNp63 immunohistochemical staining will be used to make a classification diagnosis of cervical intraepithelial neoplasia(CIN),We will have a preliminary understanding of the relationship between the expression level of P16,Ki67 and ΔNp63 with different levels of cervical lesions;2.Further investigations will be done to evaluate the biological markers,which may be useful for the clinical diagnosis of HSIL.Mehtods:A total of 270 cervical samples,which were selected from the Second hospital of Shanxi Medical University form January 2015 to December 2015.These samples were selected according to the results of pathological diagnosis by routine HE staining,then these were divided into four groups,including normal cervical group(60 cases),LSIL group(CIN1 group,cases),HSIL group(120 cases,CIN 2 and CIN 3 were 60 cases each)and early invasive cervical cancer group(30 cases).P16,Ki67 and ΔNp63 protein were detected in cervical tissues by using immunohistochemistry S-P method.The experimental results were analyzed by SPSS 20.0 software.Results:1.The expression of P16,Ki67 and ΔNp63 was correlated with the level of cervical lesions;2.The positive expression rates of P16,Ki67 and ΔNp63 in normal group,LSILgroup,HSIL group and cervical cancer group :the positive rates of P16 were 18.33%,73.33%,95.83%,100%,the positive rates of Ki67 were 10%,63.33%,87.50%,100%,ΔNp63 positive rates were 6.67%,81.67%,96.67%,100%.The positive expression rate of three indexes increased with the elevation of cervical lesions,and the differences between the four groups were positive;3.The positive expression of P16,Ki67 and ΔNp63 in HSIL group was significantly different from that in normal group and LSIL group,and there was no significant difference with cervical cancer group;4.The sensitivity and specificity of the positive diagnosis of ΔNp63 protein were95.0% and 96.7% respectively,which were higher than those of Ki67(87.5% and 90.0%).The specificity was similar to that of P16,but the sensitivity was relatively high;5.ROC curve analysis: The area under the curve of ΔNp63 was 0.958(95% CI0.924-0.993),which was higher than that of P16 and Ki67,and the area under the curve of Ki67 was statistically significant but not for P16.Among the multiple joint detection methods containing ΔNp63,the area under the curve in parallel with ΔNp63 and P16 was the largest(0.950),and there was no significant difference compared with the area under the curve of ΔNp63 alone(0.958).Conclusions:1.The semi-quantitative score of P16,Ki67 and ΔNp63 immunohistochemical staining can reflect the degree of CIN lesions objectively;2.ΔNp63 could be a high potential marker of cervical cancer-related;3.These biological indicators has certain guiding significance effective for screening and enhancing the accuracy of HSIL diagnosis in clinical practice.