P16,Ki-67 And P63 In Cervical Intraepithelial Neoplasia Expression And Clinical Significance

Background and ObjectiveCervical cancer is one of the third gynecological malignant tumors that seriously threaten the health of women.The morbidity of cervical cancer is the highest among gynecologic malignant tumors.In recent years,with the improvement of early screening programmes and treatment methods,the morbidity and mortality of cervical cancer have decreased significantly in developed countries.But in developing countries,the morbidity is still high and has a younger trend.Cervical intraepithelial neoplasia(CIN)is a group of precancerous lesions closely related to cervical infiltration cancer.If the treatment is given during CIN stage,the progression of the disease can be blocked.The premise of early treatment is early diagnosis.The diagnosis of cervical cancer is based on histological results which was defined as"gold standard".The biopsy specimens of most patients can be clearly diagnosed by HE staining,whereas a few patients should be identified by immune-histochemical staining.Currently,the most commonly used biomarkers in clinic are P16,Ki-67,P63,and so on.The relationship between these three and CIN has been reported.However,there is still a certain false negative rate and misdiagnosis rate in the diagnosis of CIN,and the diagnostic value remains to be studied.This study used IHC to detect the expression of P16,Ki-67 and P63 in tissue samples to explore the relationship between these three biomarkers and CIN levels.By comparing the diagnostic value of the three separate tests and combined tests for cervical lesions at different levels,the best diagnosis method was selected to improve the accuracy of early diagnosis of cervical cancer.MethodsCollected data of patients with cervical biopsy from September 2017 to December2017 at the cervical center of the People's Hospital of Zhengzhou University.According to the pathological diagnosis of HE staining,the results were divided into cervicitis group,CIN I group,CIN II and CIN III group.In each group,40 cases were randomly selected as the study subjects,totally 160 cases.The paraffin specimens were collected and the expression of P16,Ki-67 and P63 in each group was detected by immunohistochemical S-P staining.We analyzed the expression of three biomarkers in different levels of cervical lesions,and to compared the diagnostic value.Results1.No statistical differences in age between the groups(F=0.418,P=0.740>0.05).2.The expression positive rate of P16,Ki-67 and P63 increased followed the related lesion level,and the differences among the groups were statistically significant(?~2=79.341,?~2=45.355,?~2=84.121,P<0.001).3.The distribution of P16 and P63 positive cells in the cervical epithelial tissue and the index of Ki-67 positive cells were positively correlated with the CIN level(r=0.835?r=0.707?r=0.576,P<0.001).4.P16,Ki-67 and P63 have good diagnostic value for CIN.“P16 or P63”group has the highest diagnostic value of LSIL(0.800);“P16 and P63”group has the highest diagnostic value of HSIL(0.960).Conclusion1.The positive expression of P16,Ki-67 and P63 is of significance to the diagnosis of CIN.2.P16 and P63 positive cell distribution and Ki-67 marker index were positively correlated with the lesion level,which could help predict the severity of lesion.3.P16 combined with P63 can improve the diagnostic accuracy of CIN.