Expression And Practical Value Of STMN1、P16and Ki-67in The Diagnosis Of High-grade Cervical Intraepithelial Neoplasia

ObjectiveA main controversy in using biomarkers to diagnose cervical cancer precursors [ie,squamous intraepithelial lesions (SIL)] is their lack of specificity for high-grade SIL[HSIL;cervical intraepithelial neoplasia grade2/3(CIN2/3)]. We investigate the expression andsignificance of STMN-1(Stathmin1, a microtubule-destabilizing protein vital in mitosis)、P16、Ki-67in the CIN and cervix carcinoma to make sure whether the STMN-1could beused as a diagnostic marker in cervical SILs.MehtodsA total of150cervical samples, including cervicitis（n=30）,uterine cervix cancer（n=30）and squamous lesions, were evaluated for STMN1, P16, and Ki67expression byimmunohistochemical analysis. CIN were independently scored and classified aslow-grade SIL (LSIL/CIN1,n=30), and HSIL(including CIN2and CIN3，n=60) on thebasis of a majority diagnosis.Results1．STMN1was positive in23.33%(7/30) cervicitis,60%(18/30) LSIL,93.33%(56/60) HSIL and all uterine cervix cancer (30/30) cases. For STMN1group, there wassignificantly different between the LSIL and HSIL. Meanwhile, the expression degree wassignificance difference in multiple comparison among above grade（sX2=9.366, X2=24.890,X2=10.946）. In contrast,10%(3/30) cervicitis,56.67%(17/30) LSIL,96.67%(58/60)HSIL and all uterine cervix cancer (30/30) were P16positive，63.33%(19/30) cervicitis,90%(27/30) LSIL,95%(57/60) HSIL and96.67%(29/30) uterine cervix cancer wereKi67positive.2．STMN1,P16and Ki67were highly positive in HSIL(93.33%,96.67%,95.00%), but decreased in LSIL(60.00%,56.67%,90.00%).There was significance difference inexpression comparison.3．To high-grade CIN, STMN1was good at both diagnostic sensitivity（93.33%）andspecificity（58.33%）.4．During the HSIL group comparison, there was no correlation between the STMN1and P16（P=0.765）, neither STMN1nor Ki67（P=0.703）.ConclusionsThese results demonstrate that STMN1is overexpressed in virtually most HSIL andcervical carcinomas. Expression degrees of STMN1were increased with thetransformation from CIN to uterine cervix cancer which shows preponderance at cervicaltissue diagnosis. STMN1overexpression appears independent of proliferation, maturation,and human papilloma virus cytopathic effect and may be useful diagnostically inidentifying HSIL. Combine STMN1、P16and Ki-67may be a useful method for earlydiagnosis of cervix carcinoma which guiding the clinical appplication.