The Significance Of P16^INK4a,Ki-67 And Telomerase Expression In Squamous Epithelial Lesion Of Cervix

Objective:1) To analyse the proportion of cervical carcinoma and cervical intraepithelial neoplasia (CIN) in different period, different age and different race during the past 21 years in Affiliated Tumor Hospital of Xinjiang Medical University, and to explore the changes of the cervical carcinoma and CIN incidence.2) To explore the significance of P16INK4a, Ki-67 and Telomerase in squamous epithelial lesion of cervix, the relation between these three indexes and HPV16 infection. Methods:1) The patient's age, race and pathological characteristics of the cervical epithelial lesion were retrospectively analyzed in 18304 cases during 1989-2009.2) Immunohistochemical method (PV-9000) were used to detect the expression of P16INK4a, Ki-67 and Telomerase in squamous epithelial lesion of cervix, meanwhile analyse the relation between them and the data of HPV16 infection. Results:1) 5891 cases cervical carcinoma had been detected, the highest proportion in 60～64 years old,4440 (75.37%) cases were Uighur. The proportion of cervical carcinoma was gradually decreased (57.73%→18.78%).2) 2601 cases CIN had been detected, the patients of CIN1and CIN2-3 consisted mainly in 30～34 and 35～39 years old respectively. The average age of CIN was gradually decreased (P<0.01).1745 (67.09%) cases were Han. The proportion of CIN was gradually increased (CIN1 1.20%→6.72%, CIN2-3 3.50%→13.26%).3) Most of the histological types of cervical carcinoma which had been detected were moderately differentiated cervical squamous cell carcinoma (66.13%), mainly were Uighur (2957,75.90%).4) the positive rate of P16INK4a were 0.00%(chronic cervicitis),73.33%(CIN1),82.50%(CIN2),90.38%(CIN3) and 95.24% (SCC), respectively. The positive rate of Ki-67 were 0.00%(chronic cervicitis),91.11% (CIN1),94.29%(CIN2),96.15%(CIN3) and 100.00%(SCC), respectively. The positive rate of telomerase were 0.00%(chronic cervicitis),100.00%(CIN1),100.00%(CIN2), 82.35%(CIN3) and 89.47%(SCC), respectively.5) Moderate positive correlation between the expression of P16INK4a and Ki-67 (rs=0.554,P.000) were found.6) The expression of P16INK4a and Ki-67 showed low positive correlation with HPV16 infection (r=0.379, P=0.000; r=0.306,P=0.006), and there were no significant correlationship between the expression of Telomerase and HPV16 infection (P=0.449). Conclusion:1) The proportion of cervical carcinoma was gradually decreased, there's a high proportion in 60-64 years old, and most of them were Uighur.2) The proportion of CIN was gradually increased, the highest proportion was in 30-39 years old, the average age of CIN was gradually decreased, most of the patients were Han.3) Most of the histological types of cervical carcinoma were moderately differentiated cervical squamous cell carcinoma, mainly were Uighur.4) The high expression of P16INK4a and Ki-67 related to HPV16 infection.5) The high expression of P16INK4;1, Ki-67 and Telomerase were helpful to the diagnosis of CIN 1 from chronic cervicitis.6) The combined detection of P16INK4a, Ki-67 and Telomerase may be helpful marker in grading of CIN, the higher of the positive rate and strong staining of P16INK4a and Ki-67, the higher of the CIN grade.