Expression Of P16 And Ki67 In Different Cervical Tissue Lesions And Their Correlation With HPV

Objective:1.By detecting the expression of p16 and ki67 proteins in different levels of cervical lesions,the clinical significance of p16 and ki67 proteins in grading diagnosis and treatment of cervical lesions was discussed;2.To analyze the relationship between HPV subtypes and the expression intensity of p16 and ki67,To further clarify the correlation between p16 and ki67 protein expression and HPV infection,to provide useful value for practical clinical diagnosis and treatment.Methods: Cervical cell specimens of women admitted to the affiliated hospital of qinghai university from September 2016 to September 2019 were collected.TCT and HPV tests were performed,and 300 HPV positive patients were screened.According to the pathological results of HE staining,they were divided into 64 cases of cervical inflammatory disease(cervicitis group),65 cases of CINI group(LSIL group),60 cases of CINII group,65 cases of CINIII group(HSIL group),and 67 cases of cervical squamous cell carcinoma(cervical cancer group).Immunohistochemical staining s-p method was used to detect the protein indexes of p16 and ki67 in each group and compare their expression levels in each group.The data were classified and processed by statistical software,and the results of HPV,TCT,pathology and immunohistochemistry were recorded.According to the pathological results,the data were divided into the above 5 groups and counted.Results: 1.In the chronic cervicitis group,CINI group,CINII group,CINIII group,and cervical cancer group,the positive expression rates of p16 were 7.8%,31.6%,66.1%,95.0%,and 100.0%,respectively,and the positive expression rates of ki67 were 9.4%,33.3%,87.1%,100.0%,100.0%.The higher the level of cervical lesions,the stronger the positive expression rate of p16 and ki67,and the difference was statistically significant(P <0.001).2.According to the positive expression of p16 protein,it is mainly localized in the cytoplasm and nucleus,and is divided into negative(-),weak positive(+),positive(++),and strong positive(+++);The positive expression of p16 in the inflammation group was 1+(7.8%,5/64);the positive expression of CINI-grade p16 was 1+(28.1%,16/57)and 2+(3.5%,2/57);The positive expression of CINII grade p16 was 1+(33.9%,21/62),2+(32.3%,20/62);the positive expression of CINIII grade p16 was 1+(15.0%,9/60),and the majority was 2+(46.7%,28/60)and 3+(33.3%,20/60);p16 expression in the cervical cancer group was 2+(32.3%,20/62),and most expression was 3+(67.7%,42/62).ki67 positive signal is located in the nucleus.It is divided into 6%-25% of positive cells as +,26%-50% as 2+,and> 50% as 3+.For the inflammation group,ki67 positive expressions were 1+(7.8%,5/64)and +(1.6%,1/64);CINI-grade ki67 positive expressions were mostly 1+(29.8%,17/57)and 2+.(3.5%,2/57);ki67 positive expressions of CINII grades were 1+(46.8%,29/62),2+(37.1%,23/62),and 3+(3.2%,2/62);CINIII grade ki67 positive expression was 1+(11.7%,7/60),mostly expressed as 2+(51.7%,31/60)and 3+(46.7%,22/60).ki67 positive expression in cervical cancer group was 2+(30.6%,19/62),mostly expressed as 3+(69.4%,43/62).As the degree of cervical lesions gradually increased,the expression intensity of p16 and ki67 also increased correspondingly,and there were differences between the five groups(P <0.05).From the correlation analysis,it can be concluded that the Spearman rank correlation coefficients of p16 and ki67 positive expressions were 0.851 and 0.862(P <0.001),indicating that the expressions of p16 and ki67 were positively correlated with different levels of CIN.3.According to different subtypes,HPV is divided into single high-risk HPV infection,single low-risk HPV infection,and mixed infection type(HPV infection of more than two subtypes).Among the 28 HPV types tested,the top 6 subtypes with the highest infection rate were screened in order: 27.2%(83/305)of type 16,17.4%(53/305)of type 58,and 6.2%(19/305 of type 33).),Type 18 5.6%(17/305),type 45 4.0%(12/305),type 52 4.0%(12/305);58 cases of high-risk mixed infection,the infection rate was 19.0%(58/305).HPV-16,HPV-58,HPV-33,HPV-45,HPV-52,and high-risk mixed types were related to the expression intensity of p16,and the differences were statistically significant(?~2 = 12.247,8.823,7.156,6.569,5.196,11.062,all P <0.05).HPV-16,HPV-58,HPV-33,HPV-45,HPV-52,and high-risk mixed types were associated with ki67 expression intensity,and the differences were statistically significant(?~2 = 15.527,12.945,8.901,7.615,5.487,16.322,all P <0.05).Conclusion: 1.the positive expression rates of ki67 and p16 in cervical lesion tissues of different levels were different,and with the increase of the level of cervical intraepithelial neoplasia,the expressions of p16 and ki67 were also gradually enhanced.2.The expressions of ki67 and p16 are correlated with high-risk HPV infection.In the prevention and treatment of HPV infection,we should focus on the prevention and treatment of HPV-16,HPV-58,HPV-33,HPV-45,HPV-52,and high-risk mixed infections.It is suggested to pay attention to the monitoring and prevention of these viruses in clinical work.