海南医科大学学报

目的:探讨PCNA、Ki-67在宫颈癌、宫颈上皮内瘤变(CIN)中的表达意义及与高危型人乳头瘤病毒(HR-HPV)感染的关系。方法:收集手术切除的宫颈标本280例,其中,研究组中宫颈癌72例,CIN148例,对照组中慢性宫颈炎60例。应用免疫组化检测宫颈标本中增殖细胞核抗原(PCNA)、Ki-67抗原的表达情况,采用PCR技术检测宫颈标本中HR-HPV感染情况。结果:宫颈癌组、CIN组PCNA表达阳性率明显高于宫颈炎组,且宫颈癌组、CINⅡ~Ⅲ组PCNA阳性率高于CINⅠ组,差异具有统计学意义(P<0.05);宫颈癌组、CIN组Ki-67表达阳性率明显高于宫颈炎组,且宫颈癌组、CINⅡ~Ⅲ组Ki-67阳性率高于CINⅠ组,差异具有统计学意义(P<0.05);宫颈癌组、CIN组、PCNA、Ki-67过表达情况明显高于宫颈炎组,且CINⅡ~Ⅲ组PCNA、Ki-67过表达率明显高于CINI组,差异具有统计学意义(P<0.05);PCNA表达强度与HPV感染呈现正相关(r=0.706,P=0.011);Ki-67表达强度与HPV感染呈现正相关(r=0.695,P=0.021)。结论:PCNA、Ki-67在早期宫颈癌及不同级别CIN中的表达存在很大差异,不同级别CIN中HPV感染率亦存在较大差异,因此临床上可以通过联合检测HPV、PCNA、Ki-67等指标对早期宫颈癌、CIN进行辅助诊断。

Objective:To study expression of PCNA,Ki-67 in early cervical cancer and cervical intraepithelial neoplasia and the correlation with high-risk HPV infection.Methods:Cervical specimens collected from 280 patients during operation resection were collected and set as the study group,and among them,there were 72 cases of cervical cancer,148 cases of CIN,60 cases of chronic cervicitis in control group.Immunohistochemical detection of proliferating cell nuclear antigen in cervical specimens(PCNA),the expression of Ki-67 antigen were made,and PCR technology was used for high-risk HPV infection in detecting cervical specimens.Results:Expression of PCNA positive rate in cervical cancer group,CIN group,was significantly higher than that of chronic cervicitis group(P<0.05),and in cervical cancer group,CIN Ⅱ~Ⅲ group the positive rate of PCNA was higher than that of CIN Ⅰ group(P<0.05).Expression of Ki-67 positive rate in cervical cancer group,CIN group,was significantly higher than that of chronic cervicitis group(P<0.05),and in cervical cancer group,CIN Ⅱ~Ⅲ group the positive rate of Ki-67 was higher than that of CIN group Ⅰ(P<0.05).In cervical cancer group,CIN group,PCNA,Ki-67 expression was significantly higher than that in chronic cervicitis group(P<0.05).And in the CIN Ⅱ~Ⅲ group PCNA,Ki-67 expression rate was significantly higher than group CINI(P<0.05).The expression of PCNA showed a positive correlation with the intensity of HR-HPV infection(r=0.706,P=0.011);the expression of Ki-67 showed a positive correlation with the intensity of HR-HPV infection(r=0.695,P=0.021).Conclusion:There is a great difference between the expression of PCNA,Ki-67 in early cervical cancer and different levels of CIN,and there is great difference between the rates of HR-HPV infection in different levels CIN,and therefore clinically we can use combined detection of HR-HPV,PCNA,Ki-67 and other indicators for early cervical cancer,CIN diagnosis.