The Cytological Examination Of P16,Ki67,CK14 And HPV Infection In The Diagnosis Of Cervical Intraepithelial Neoplasia

Objectives By examining the expression of P16,Ki67,and CK14 in exfoliated cells of human cervical epithelial cells,and comparing the result with cervical liquid-based cytology test(TCT)and high-risk human papillomavirus test(HR-HPV),the understanding of P16,Ki67,CK14 The relationship between expression and cervical intraepithelial neoplasia(CIN)was discussed,and the value of P16,Ki67 and CK14 immunocytochemical markers in the screening of cervical intraepithelial neoplasia was explored.Methods Screening of TCT and HR-HPV examinations in gynecological outpatient clinics of Tangshan Workers' Hospital from September 2016 to September 2017.Colposcopy and cervical biopsy were performed on patients with high positive results or clinical symptoms.Histopathological diagnosis was 91 patients with CIN collected their cervical exfoliated cells as a study sample.According to the results of histopathological diagnosis,they were divided into 3 groups: CIN1,CIN2,and CIN3.The control group was exfoliated cells in non-cervical lesion patients.Immunocytochemistry was used to detect the expression of P16,Ki67 and CK14 in cervical exfoliated cells of each group.The expression of P16,Ki67,CK14 and HPV infections and the sensitivity of each group were analyzed by correlation analysis.The comparison of specificity,positive predictive value,and negative predictive value evaluated the value of TCT,HPV,and P16,Ki67,and CK14 tests in the diagnosis of cervical intraepithelial neoplasia.Results All tissue biopsies from all tissues were histopathologically diagnosed and histologically diagnosed.All specimens were examined by TCT and HPV.The positive predictive values of TCT and HPV were 97.6% and 96.7% respectively.The expressions of P16,Ki67 and CK14 in cervical intraepithelial neoplasia were higher than those in the control group.Difference(P<0.05).The positive expression rates of P16 in CIN1,CIN2,and CIN3 groups were 58.8%,84.0%,and 100%,respectively;the positive expression rates of Ki67 in CIN1,CIN2,and CIN3 groups were 64.7%,88.0%,respectively.The positive expression rates of CK14 in the CIN1,CIN2,and CIN3 groups were 64.7%,88.0%,and 96.8%,respectively;P16 and Ki67 combined double staining were positive in the CIN1,CIN2,and CIN3 groups.The expression rates were 94.1%,96.0%,and 100.0%,respectively.The expression rates of P16,Ki67,CK14,P16 and Ki67 combined with double staining were statistically significant(P<0.05).The sensitivity,specificity,positive predictive value,and negative predictive value of P16 were 80.2%,90.0%,96.1%,and 60.0%,respectively;the sensitivity,specificity,positive predictive value,and negative predictive value of Ki67 were 82.4% and 73.3%,respectively.90.4%,57.9%;the sensitivity,specificity,positive predictive value and negative predictive value of CK14 were 82.4%,83.3%,93.7%,and 60.9%,respectively.P16,Ki67 and CK14 were significantly higher in the cervical exfoliated cells in the CIN group than in the normal population.The positive expression rate increased with the increase in CIN levels.And the high-grade CIN group was significantly higher than the low-grade CIN group,the difference was statistically significant(P <0.05).Conclusions 1)P16,Ki67,CK14 can effectively detect CIN lesions,and there is a positive correlation with CIN clinical grading.2)P16,Ki67,CK14 combined detection is better than TCT or HPV alone detection,and P16,Ki67,CK14 cytology combined with TCT and HPV are more conducive to the detection rate of CIN.3)P16 and Ki67 double staining are more helpful to determine the CIN lesion level than the detection of P16,Ki67 and CK14 alone.4)The expression of P16 and Ki67 was correlated with HPV infection.There was no significant correlation between the expression of CK14 and HPV infection.5)P16,Ki67,CK14 can be used as an early screening aid for cervical intraepithelial neoplasia,providing some guidance for clinical treatment.