P16 And Ki67 In Cervical Intraepithelial Neoplasia Expression And Clinical Significance

Objective:By testing the expression of P16、Ki67 in different cervical tissues and understanding the relationship of P16、Ki67 in different levels of cervical intraepithelial neoplasia(CIN)Delta, especially the relationship between high level cervical intraepithelial neoplasia, combining the grade diagnosis on semi-quantitation score of P16、Ki67, this study investigate the function and significance of P16、Ki67 on CIN pathological diagnosis. Materials:110 cases was selected Second Hospital of Jilin University in 2015 from 1-12 month period, by HE staining pathological diagnosis in our hospital outpatient and inpatient HPV inspection to detect 20 cases of chronic cervicitis, 30 cases of CINⅠgrade, 30 cases of CINⅡ, 30 cases of CINⅢ grade. The above data are divided into four groups: group inflammation, CINⅠlevel group, CINⅡlevel group, CINⅢ level group. Method:Firstly, the samples of cervical tissue was used to the HE staining pathological diagnosis and reexamined by 3 high qualification pathologic doctor.2. After HE staining, we re-stain the worse part of lesions, then there is a pathologist who takes the semi-quantitation score and classify the cervical lesions.3. According to the statistical analysis methods, this group of data between multiple sets of normal distribution of quantitative data using analysis of variance, quantitative data does not meet the normal distribution using the non-parametric test, count data using chi-square test; P16 and Ki67 in the United column analysis. Comparison of the two pathological diagnosis use the Kappa consistency analysis. Results:1. This group of patients P16, Ki67 positive in CIN was 77.27%, 72.72%, P16, Ki67 positive intensity increases with the increase in the level of the lesion.P16 correlation coefficient = 0.713, p <0.001, within P16 and cervical intraepithelial neoplasia change are closely related. P16 level in CIN I, CINⅡ level CINⅢ level positive rate was 83.30%, 100%, 100%, respectively.Ki67 in CIN I grade, CINⅡ grade level CINⅢ positive rate was 66.67%, 100% and 100%, respectively. Statistically significant difference. Ki67 correlation coefficient = 0.644, P <0.001, statistics show that Ki67 is closely associated with cervical lesions.When the two main categories P16 expression LSIL group was: 16.67% negative, positive 83.33%; HSIL is expressed as a negative 0,100%; the main expression of Ki67 LSIL group: negative 33.33%, 66.66%; HSIL is expressed as a negative 0, 100% positive, among the above group differences were statistically significant.P16 pathological diagnosis sensitivity 94.44%,specificity of 100%。Ki67 pathological diagnosis sensitivity 88.89%,specificity of 100%。 P16, Ki67 pathological diagnosis sensitivity and specificity CIN disease are stronger.2. The combination of P16, Ki67 semi-quantitative Rating: chronic cervicitis group P16, Ki67 expression was detected in all(100%). CINI combined major combination P16 2 +, Ki67 2+ 10 Li, P16 1 +, Ki67 2+ 7 Li, P16 2 +, Ki67 1+ 4 Li, CINⅡ combined major combination P16 2 +, Ki67 3+ 18 Example, P16 3 +, Ki67 2+ 5 cases, P16 3 +, Ki67 3+ 5 cases, CINⅢ in combination with at least a 4+ 29 cases.3. The combination of P16, Ki67 semi-quantitation score grade cervical lesions, and H & E stained histological grade compared diagnosis, diagnosis of chronic cervicitis group segment consistent rate of 100%. CINI consistent rate 86.67%, CINⅡ level consistent rate of 93.33%, CINⅢ level consistent rate of 96.67%, LSIL concordance rate 86.67%, HSIL consistent rate of 90%. Conventional staining and immunohistochemical staining consistent application of Kappa analysis, P <0.001, Statistics believe that Kappa≥0.75 can show better consistency; These data indicate Kappa value 0.915, suggesting immunohistochemistry staining with ordinary tissue diagnosis of high consistency.4. P16 sensitivity, specificity, Ki67 sensitivity, specificity, suggesting that the two can improve the pathological diagnosis of cervical lesions repeatability. Conclusion:1.Ki67, P16 can effectively show the severity of cervical intraepithelial neoplasia.2. The two combined diagnosis can objectively reflect the degree of cervical intraepithelial neoplasia.3. Ki67, P16 joint semi-quantitation score can enhance the accuracy and repeatability on pathological diagnosis and reduce errors caused by subjective factors among pathologists produced, giving a more accurate and reliable clinical diagnosis basis.4. Combined regular staining and immunohistochemical staining can effectively improve cervical intraepithelial neoplasia grade diagnostic confidence.