Differential Diagnosis Of P16,Ki67 In Cervical Intraepithelial Neoplasia Grades And Correlations To HrHPV

Objective Detecting the expression of P16, Ki67 and the infection of Human Papillomaviral in different Cervical Intraepithelial Neoplasia Grades. Exploring the diagnostic function of P16, Ki67 in low-grade CIN and high-grade CIN and the relationship between P16, Ki67 and High-risk Human Papilloma- viral in different Cervical Intraepithelial Neoplasia Grades. So that we can provide dependable warrant for father therapy.Method (1)Immunohistochemical staining was used to detect the expression of P16, Ki67 in 261 various cervical lesions and 30 normal cervical intraepithelial. (2) HPV-DNA virus load of the cervical samples were detected by hybrid captureâ…¡(HCâ…¡) system.Results (1)The results of immunohistochemical were as follows. No expression of P16 protein and Ki67 were observed in the normal cervical epithelial. However, P16 protein and Ki67 expressed in CIN increased gradually with progression of lesions and the positive expression rate were significantly different between CIN1 and CIN2, CIN2 and CIN3, CIN1 and CIN3 (P<0.001). In high-grade CIN(CIN2-3), P16 and Ki67 expression rates were significantly higher than low-grade CIN(CIN1)(P<0.001). We also found that the expression of P16 and Ki67 had obviously layers. For the distribution of P16 and Ki67 staining ,P16 and Ki67 positive cells were distributed mainly in the lower third of the epithelial layer in CIN1 group cases. In CIN2 group,positive cells were distributed in up half of the epithelium. In CIN3 group,positive cells were distributed in up 2/3 or full of the epithelium. Expression of P16 was significantly correlated with Ki67 in different grade CIN(R=0.941,p<0.01).(2) The results of HCâ…¡were as follows. The positive expression rate of HPV-DNA were51.4%(54/105), 73.8%(62/84)and 98.6%(71/72) correspondingly in CIN1, CIN2 and CIN3 . And the positive expression rate of HPV-DNA in CIN increased gradually with progression of lesions and the positive expression rate was significantly different between high-grade CIN and low-grade CIN (P<0.001). The positive expression rate of P16 was 89.3% and Ki67 was 89.8% in 187 HPV-DNA positive cases. And with the expression rate of HPV-DNA increased gradually , the positive rate of P16 protein and Ki67 increased. Expression of P16 and Ki67 was significantly correlated with HPV infection(R=0.905 ,P<0.001and R=0.941 ,P<0.001).Conclusions (1)The co-operation expression of P16 and Ki67 could be a better biomarker for the early diagnose of CIN. (2)The expression of P16,Ki67 is increased along with the enhancement of the grade of CIN. P16 and Ki67 can be used as surrogate markers to distinguish high-grade CIN from low-grade CIN, which improves the results of histological classification. So that we can provide dependable warrant for father therapy. (3) Along with the positive rate of HPV-DNA increased, the degree of cervical intraepithelial lesions increased. So that the positive rate of hrHPV reflected the degree of cervical intraepithelial lesions. (4) Expression of P16 and Ki67 was significantly correlated with hrHPV infection.