Expression And Signficance Of Survivin, Ki-67 Before And After Loop Electrosdurgical Excision Procedure Of Cervical Intraepithelial Neoplasia

Objective:(1)Through detecting the expression levels of Survivin and Ki-67 in normal cervical tissues,cervical intraepithelial neoplasia(CIN) and cervical squamous cell carcinoma(SCC), the correlation between their expression levels and pathology, especially with the CIN grading was analyzed.(2)Through comparing the expression levels of Survivin and Ki-67 before and twelve months after Loop electrosurgical excision procedure(Leep)of CIN, invest the relation between the expression levels and the therapeutic effects. The clinical implications of Survivin and Ki-67 in evaluating the therapeutic effects after treatment was studied.Methods:The expression of Survivin and Ki-67 before and after Leep of sixty eight cases of CIN (twenty three cases of CINâ… ,twenty one cases of CINâ…¡,twenty four cases of CINâ…¢)was detected by innunohistochemical S-P method and the relationship among the expression of Survivin,Ki-67,the therapeutic effects and the prognosis were discussed. Fifteen cases of normal cervical tissues and fifteen cases of SCC were taken as control groups.Results:(1)The positive expression rate of Survivin in normal cervical tissues,CIN and SCC:in normal cervical tissues was 0.00%(0/15); in CINâ… was 26.09%(6/23); in CINâ…¡was 57.14%(12/21); in CINâ…¢was 83.33%(20/24); in SCC was 86.67%(13/15); the differences was statistically obvious(P<0.05). Pairwise comparison:The positive expression rate of Survivin marker:CINâ… was superior to normal cervical tissues; CINâ…¡was superior to CINâ… ; CINâ…¢was superior to CINâ…¡; SCC was superior to CINâ…¢; there was statistical differences (P<0.05).(2)The positive expression rate of Ki-67 marker in normal cervical tissues,CIN and SCC:in normal cervical tissues was 0.00%(0/15); in CINâ… was 30.43%(7/23); in CINâ…¡was 61.90%(13/21); in CINâ…¢was 87.50%(21/24); in SCC was 93.33%(14/15); there was statistical differences(P<0.05). Pairwise comparison:The positive expression rate of Ki-67: CINâ… was superior to normal cervical tissues; CINâ…¡was superior to CINâ… ; CINâ…¢was superior to CINâ…¡; there was statistical differences(P<0.05). There was no statistical difference between SCC and CINIII (P>0.05).(3)Correlational analysis:The positive expression rate of Survivin marker in normal cervical tissues,CIN and SCC had a positive correlation with Ki-67(r=0.92,P<0.05); twelve months after Leep treatment, there was positive correlation between the expression of Survivin and the expression of Ki-67(r=0.71,P< 0.05).(4)Twelve months after Leep treatment, the positive expression rate of Survivin marker in CIN I was 0.00%(0/15); in CINâ…¡was 9.52%(2/21); in CINâ…¢was 13.64% (3/24); the cases of positive expression decreased significantly after treatment, there was statistical differences before and after treatment in the three groups(P<0.05).(5)Twelve months after Leep treatment, the positive expression rate of Ki-67 marker in CINâ… was 0.00%(0/15); in CINâ…¡was 14.29%(3/21); in CINâ…¢was 16.67%(4/24); the cases of positive expression decreased significantly after treatment, there was statistical differences before and after treatment in the three groups(P<0.05).(6)Based on histopathological analysis:Twelve months after Leep treatment, the curerative(CR) of CIN was 94.12%(64/68).The CR of CINâ… was 100.00%(23/23); CINâ…¡was 90.48(19/21); CINâ…¢was 91.67%(22/24). Twelve months after Leep treatment, the CR of CINâ… was superior to CINâ…¡;the CR of CINâ…¢was superior to CINâ…¡; there was statistical differences (P<0.05). But there was no statistical difference between CINâ…¢and CINâ…¡(P>0.05).Conclusion:(1)The rate of the positive expression of Survivin and Ki-67 in normal cervical tissues,CIN and SCC was showing increasingly varied with the aggregation in cervix lesion.(2)Twelve months after Leep treatment of CIN, the positive expression rate of Survivin and Ki-67 was statistical decreased. There was positive correlation between Survivin and Ki-67 before and after Leep treatment.(3)Leep is a safe and effective treatment method for patients with CIN. Joint detect the expression of Survivin and Ki-67 have some guidance meaning to predict the severity of the lesion,the therapeutic of Leep and the prognosis.