Study On The Diagnosis Of Cervical Lesions In The Relationship Between The Reid Score And The Expression Of P16 And Ki-67

Objective 1.Studying of Reid’s Colposcopic Index in the diagnostic value of cervical lesions.2.Correlation analysis between Reid score and the expression of P16 and Ki-67 in cervical lesions and its clinical diagnostic significance.Method A total of 91 cases were selected from the department of Pathology,Jinan Maternity and Child Health Care Hospital.These cervical tissue paraffin block specimens were selected on December 2014 to 2015 March and divided into:24 cases in group A(CINI),34 cases in group B(CINII),13 cases in group C(CINIII),10 cases in group D(squamous cell carcinoma,SCC),10 cases in group E(normal cervical intraepithelial,NCE).The group E was the control group which confirmed by pathology of normal cervical intraepithelial and the rest of the groups were experimental groups which obtained specimens through cervical biopsy and LEEP underwent colposcopy.After the experience of the colposcopy doctors on patients underwent colposcopy and biopsy and diagnosis to Reid score.By pathologists review of HE slices in accordance with the WHO standard,and then selected two or more consistent diagnostic opinions of physicians.Two-steps method in immunohistochemistry was used to detect the expression level of P16 and Ki-67 in cervical lesionns.Analyzing the correlation between Reid’s Colposcopic Index and the expression of P16 and Ki-67.Using SPSS17.0 statistical software to analyze the experimental data and P<0.05 was considered statistical significant.Results 1.Each group Reid score of four indicators compared with pathological diagnosis and the differences were statistically significant(P<0.05).In the five groups,there was no significant difference between the Reid score of the NCE and the CINI(P<0.05).There were statistically significant differences between the Reid score of the NCE,the CINII,the CINI and the CINII.The Reid score of the CIN III and the other groups were compared which di-fferrences have statistical significance(P<0.05).In all cases,the coincidence rate of Reid score’s diagnosis and pathological diagnosis was 80.22%.Reid score and pathological diagnosis of high-grade squamous intraepithelial lesions(HSIL)and low-grade squamous intraepithelial lesions(LSIL)of the coincidence rate were 26.37% and 73.63%respecttively.2.The positive rate of P16 and Ki-67 in the NCE,CINI,CINII,CINIII and SCC were10%,95.83%,97.06%,100%,100%and 20%,95.83%,100%,100%,100% respectively.With the increase of CIN pathological grade,the positive intensity of P16 and Ki-67 increased(P<0.05)in the CIN group.The SCC group showed strong positive.The IHS score of three groups that the CINI,the CINII and above the CINII level and IHS score of NCE(control group)were compared by rank sum test,which the results indicated that each group compared with the control group the difference was statistically significant(P<0.05).The four group that the NCE,the CINI,the CINII and above the CINII staining results by Spearman rank correlation test showed that IHS score of each group had highly positive correlation with pathological grades(P16:r_s=0.882,P=0.000;Ki-67:r_s=0.862,P=0.000).Correlation analysis showed that there is a positive correlation between P16 and Ki-67(r_s=0.826,P=0.000).The coincidence rate of IHS score and pathological diagnosis of P16 and Ki-67 were 76.92% and 64.84%.3.Reid score and IHS score of P16 and Ki-67 were compared,the difference was statistically significant(P<0.05).There is significant correlation(P16:r_s=0.751,P=0.000;Ki-67:r_s=0.741,P=0.000)and has highly positive correlation.The coincidence rate of Reid score and IHS score of P16 and pathological diagnosis was 81.32%.The coincidence rate of Reid score and IHS score of Ki-67 and pathological diagnosis was 78.02%.Conclusions 1.Four indicators of Reid’s Colposcopic Index can help the diagnosis of cervical lesions,and can identify low-grade lesions and high-grade lesions,to improve the diagnosis rate of cervical lesion(especially CINIII)and help to guide the next treatment and prognosis.2.P16 and Ki-67 are closely related to the occurrence and development of cervical lesions and they have positively correlation.The differences of the expression and IHS score of P16 and Ki-67 in cervical disease can determine the grade of cervical lesions.3.Reid’s Colposcopic Score and IHS score of P16 and Ki-67 were positively correlated.Therefore,combining with Reid score and IHS score of P16 and Ki-67 in diagnosis of cervical lesions can significantly improve the coincidence rate of pathological diagnosis,especially between CINI-CINII and CINII-CINIII treated with fuzzy diagnosis.