The Performance Of P16 And Ki67 For The Assessment Of The Women Treated For High-grade CIN

Objective:1.To analyse the relationship between the expression of P16 and Ki67 in the surgical pathologic specimens of the patients of high-grade squamous intraepithelial lesions and the detection of TCT and HPV after operation,calculate the change and overcast rate of TCT and the load of HPV-DNA,analyse the application value of the P16 and Ki67 as a indicator to predict the outcome after surgery.2.To evaluate the therapeutic effect of HSIL,shunt the follow-up of such patients after operation.Clinical guidelines for HSIL patients after surgery,find a postoperative follow-up surveillance index for follow-up shunt,avoid excessive in diagnosis and treatment of postoperative follow-up to the maximum extent,to bring the advantage to the patients.Methods:1.To collect 350 inpatients with cervical biopsy pathology for HSIL,these patient underwent cervical conization trentment.For all patients with surgical specimens for immunohistochemical staining,to detect the expression of P16 and Ki67 in the cervical lesion.2.According to the P16's vertical distribution in cervical squamous epithelium to divide the surgical specimens of all HSIL patients(350 cases)into A1 and A2 group;Also,according to the Ki67's vertical distribution in cervical squamous epithelium to divide the surgical specimens of all HSIL patients(350 cases)into B1 and B2 group.Each group corresponding to the corresponding patients.3.Follow up the TCT and HPV test results of HSIL patients postoperative for 4 years,list analysis and comparison the TCT and HPV overcast rate difference between A1 and A2?B1 and B2 group.4.Calculate multiple time node postoperatively in HSILpatients(6,12,18,24,30,36,42 and 48 months)TCT and HPV related statistical indicators(TCT score,TCT and HPV negative rate),and draw the curve analysis of the trend of the change with the time after surgery.Results:1.The overcast rate of TCT and HPV in A1 group were significantly lower than in A2 group 4 years after surgery(P?0.05).2.The overcast rate of TCT and HPV in B1 group were significantly lower than in B2 group 4 years after surgery(P?0.05).3.The negative rate of TCT is 100% in 6 months after suigery,the negative rate is gradually decreasing along with the follw-up time.4.In 36 months after surgery,the HPV-DNA load declined obviously compared with preoperative,and 42 months after surgery HPV infection positive rate significantly increased,as high as 50%.Conclusion:P16 and Ki67 have the certain value to predict the outcome of HSIL after the cervical conization.The higher expression of P16 and Ki67 in HSIL,the higher testing positive rate after surgery.TCT and HPV can from positive to negative after.Although HPV load and overcast rate have no obvious change rule,but the recurrence of 42 months may be or again the peak time of infection.