Significance Of FRα,p16 And Ki67 In Predicting The Progression Of CIN1 Lesions

Objective:Cervical intraepithelial neoplasia(CIN)is a precancerous lesion of the cervix, which is closely related to cervical cancer.About 60% of CIN1 resolve naturally.At present,only a small number of CIN1 patients are considered to require regular follow-up.Many studies have found that some biomarkers are related to the progress of CIN1,such as FRα,p16,and Ki67.The current research on FRα,p16 and Ki67 to predict the progress of CIN1 is not completely consistent.We will further study the predictive value of FRα,p16 and Ki67 through immunohistochemical experiments.Methods:From June to December 2014,we conducted free cervical cancer screening for eligible women in Jiexiu and Yangqu counties of Shanxi Province.A total of 40,000 women aged 19 to 65 were included.There were 564 cases of CIN1 when they first entered the group.Biopsy was performed again at 6,12,and 24 months after enrollment to determine whether the lesions had deteriorated.Of the 564 CIN1 women,38 were lost to follow-up.Therefore,526 women were included in our study. Immunohistochemical staining of FRα,p16,and Ki67 was performed on the cervical cancer biopsy samples of the survey subjects.Finally,other general information of these 526 women was collected for data analysis.Results:There were 5 cases of positive p16 staining and 17 cases of negative staining in the progress group;33 cases of p16 positive staining and 471 cases of negative staining in the non-progressive group.There was a significant difference in the progression rate between the patients with the p16 positive staining and the negative group;the difference was statistically significant.Significance(c(17)= 8.23,P = 0.02).The sensitivity of p16 positive to predict CIN1 progression within two years is 0.227, specificity is 0.935,positive predictive value is 0.132,and negative predictive value is 0.965.Those are the highest among the three biomarkers.The AUC(Area Under Curve)of the parallel combined diagnosis of FRα,p16 and Ki67 was 0.625(95% CI 0.582-0.666),and the difference was statistically significant(P = 0.0083).There were 15 HPV-infected patients and 7 uninfected patients in the disease progression group; 138 HPV-infected patients and 366 uninfected patients in the non-progressed group, the difference was statistically significant(c(17)= 17.01,P = 0.00).Conclusion:FR α and p16 have certain significance in predicting the progression of CIN1 lesions within two years;FRα,p16 and Ki67 in parallel may have certain significance in predicting the progression of CIN1 lesions within two years;HPV-infected CIN1 patients are more likely to develop lesions.。...