Expression Of CK7,P16 And HPV-L1 In Cervical Squamous Intraepithelial Lesion

Research background and purpose:Cervical cancer is a serious threat to women's health.Early diagnosis and treatment is recognized as the most effective means of prevention and treatment of cervical cancer.In China,the mainly method of early diagnosis is cervical cancer screening.Histopathological diagnosis as the “gold standard” to confirm what is the type and degree of cervical lesions.However,the consistency and repeatability of diagnosis of SIL,especially CIN ?,among pathologists is poor.It is interfered by many factors,and the subjective supposition of pathologists is one of the main factor.Patients' individualized "early treatment" plan relies on accurate histopathological diagnosis.The purpose of this study is to observe the expression of P16,CK7 and HPV-L1 in cervical squamous epithelial cells by immunohistochemical staining of cervical squamous epithelial tissues with different pathological degrees.Explore more reliable biomarkers and detection schemes to reduce the diagnostic errors caused by subjective factors of pathologists.To improve the accuracy and repeatability of the diagnosis of ervical squamous epithelial lesions at all levels and provide a more reliable basis for patients to develop personalized treatment plan.Materials and Methods:In this study,67 patients with cervical squamous intraepithelial lesions who were examined outpatient or treated inpatient and 16 patients with benign cervical diseases(chronic cervicitis)were confirmed by histopathology in Mianyang Central Hospital from 2018 to 2019 were collected.he expression of P16,CK7 and HPV-L1 were detected by immunohistochemistry.SPSS 22.0 statistical software was used to analyze the experimental results.Chi square test was used to compare the positive rates among groups,Fisher exact probability method was used when the chi square test conditions were not met;chi square test was also been used to analyze the correlation between indicators.ROC curve analysis is used to analyze the expression of the three indexes in different levels of CIN.AUC under ROC curve of each single index and its combination index is calculated for compare.Inspection level ? was set to 0.05,when p < 0.05,the difference was statistically significant.Result:1.The positive rates of P16 expression in chronic cervicitis,CIN ?,CIN ? and CIN ? were 0%,33.3%,91.7% and 94.6%.There were statistically significant differences between the groups(? 2 = 47.260,P < 0.001),the higher the CIN level,the higher the P16 positive rate.And when P=0.643,there was no significant difference between these two groups.2.The total positive rates of CK7 in chronic cervicitis,CIN ?,CIN ? and CIN ? were 6.2%,16.7%,83.3% and 91.9%.There were statistically significant differences between the groups(? 2 = 45.417,P < 0.001).3.The positive expression rate of HPV-L1 was 93.8% in chronic cervicitis group,66.7% in CIN? and 16.7% in CIN? group,and 10.8% in CIN? group.With the increase of cervical lesions,the positive expression rate of HPV-L1 showed a downward trend.Compare the positive expression rate between each groups,the differences was statistically significant(P < 0.05).4.Single detected the sensitivity of CIN by CK7,HPV-L1 and P16 was 85.16%,88.35% and 87.64%,and the specificity was 59.37%,47.39% and 52.18%.5.The area under the curve detected by CK7 alone is 0.855,the area under the curve detected by HPV-L1 alone is 0.878,and the area under the curve detected by P16 is 0.863.CK7,HPV-L1 and P16 all have high application value in CIN diagnosis.6.Compared with other combinations,the sensitivity of CK7,HPV-L1 combined with P16 test was significantly higher,but slightly lower specificity.The area under the curve of CIN detected by CK7,HPV-L1 combined with P16 test was 0.978,which was significantly higher than that of other combinations.The differences was statistically significant(P<0.05).Conclusion:1.The positive expression rate of CK7 in chronic cervicitis,CIN ?,CIN ? and CIN ? increased gradually,and the expression of CK7 was positively correlated with the pathological changes of CIN.It is speculated that CK7 has important value in the accurate diagnosis of different levels of CIN.2.The expression of p16 increased with the degree of cervical lesions.The positive expression rate of p16 was CIN ? > CIN ? > CIN ? > chronic cervicitis.Theexpression of p16 was positively correlated with the degree of CIN lesions.P16 was of great significance in the differential diagnosis of different levels of cervical squamous epithelial lesions.3.The expression of hpv-l1 decreased with the aggravation of cervical lesions.The positive expression rate of CIN was lower than that of chronic cervicitis.The expression of hpv-l1 was negatively correlated with the degree of cervical lesions.It was speculated that hpv-l1 might be a new biological index for differential diagnosis of cervical squamous epithelial lesions.4.The combined detection of CK7,hpv-l1 and p16 is more helpful for early detection and diagnosis of cervical squamous epithelial lesions,and for accurate classification of cervical squamous epithelial lesions,so as to provide valuable reference information for clinical treatment.