P16及Ki-67在外阴上皮内瘤变中表达及意义.docVIP

P16及Ki-67在外阴上皮内瘤变中表达及意义[摘要] 目的：观察P16和Ki-67在正常外阴组织和不同级别外阴上皮内瘤变（VIN）中的表达结果，探讨二者在VIN中的意义。方法：收集74例外阴组织，其中，30例正常外阴组织，16例低级别VIN，28例高级别VIN，采用免疫组织化学Envision法进行标记，观察P16和Ki-67的表达情况。结果：正常组、低级别VIN和高级别VIN患者P16的阳性率分别是7%、44%、100%；Ki-67的阳性率分别为10%、75%、100%；P16和Ki-67在高级别VIN和正常组、高级别VIN和低级别VIN之间的阳性表达率差异均具有统计学意义（P＜0.01）。结论：P16和Ki-67在正常外阴上皮组织，低级别VIN，高级别VIN的表达有明显差异。采用二者联合标记，更能有效的降低假阳性病例的干扰，提高VIN诊断的特异性。 [关键词] P16；Ki-67；外阴上皮内肿瘤；免疫组织化学 [中图分类号] R737.35[文献标识码]A [文章编号]1674-4721（2011）03（c）-０17－０3 Expression and significance of P16 and Ki-67 in differential diagnosis of high-grade and non-high-grade vulvar intraepithelial neoplasia LI Yuhui The People’s Hospital of Xiangxiang City, Hunan Province, Xiangxiang 411400, China [Abstract] Objective: To correlate P16 expression and cellular proliferation measured by Ki-67 staining with the degree of vulvar intraepithelial neoplasia and to determine the efficacy of these markers in diagnosing high-grade vulvar intraepithelial neoplasia (VIN). Methods: 74 vulva specimens were studied including 30 normal/reactive lesions, 16 low-grade VIN (VIN I), and 28 high-grade VIN (VIN Ⅱ andⅢ). Immunostaining (Envision method) for P16 and Ki-67 was performed. Results: The positive percentages of P16 in normal/reactive lesions, low-grade VIN, high-grade VIN were 7%, 44%, 100% respectively. The positive percentages of Ki-67 in normal/reactive lesions, low-grade VIN, high-grade VIN were 10%, 75%, 100% respectively. The espressions of P16 and Ki-67 had significant differences between the high-grade VIN and on-high-grade VIN (P＜0.01). Conclusion: Both P16 and Ki-67 are reliable markers for diagnosing high-grade VIN. [Key words] P16; Ki-67; Vulvar intraepithelial neoplasia; Immunohistochemistry 外阴上皮内瘤变（vulvar intraepithelial neoplasia,VIN）是指发生在外阴鳞状上皮内的一组不典型增生和癌前病变，可分为VINⅠ、VINⅡ、VINⅢ[1]。其中VINⅢ的复发率较高，38%的患者第一次治疗后会复发，15%~25%的患者可进展为浸润性鳞状细胞癌[2]。因此，准确的诊断出高级别VIN对患者的治疗和预后具有十分积极的意义。 长期以来对VIN的诊断主要依靠病理医生对组织切片的光镜观察，依靠医生的经验，诊断带有一定的主观性。同时由于取材的局限性，诊断误差较明显。P16和Ki-