Expression Of Survivin,P16^INK4a,COX-2 And Ki-67 In Cervical Intraepithelial Neoplasm And Cervical Squamous Carcinoma And Their Clinical Significance

Objective: To investigate the expression of Survivin, P16INK4a,COX-2 and Ki-67 in cervical intraepithelial neoplasia(CIN) and squamous carcinoma of the cervix (SCC).To analyze their correlation and significance of the synergistic expression during the occurrence and development in the SCC and infer the possibility of being biomarkers in cervical carcinogenesis.Methods: The expressions of Survivin, P16INK4a,COX-2 and Ki-67 were examined by Envision immunohistological method in paraffin-embedded tissue of 24 cases of SCC,70 cases of CIN,15 cases of cervical condyloma acuminatum ,10 cases of chronic cervicitis and 10 cases of normal cervical tissue.Results:①The expression rate of Survivin, P16INK4a ,COX-2 and Ki-67 in CIN and SCC group was remarkably higher than that in NC,CC,CCA groups (P<0.05). The positive rate and degree of their expression increased gradually from CIN to SCC.②The expression rate of Survivin was 0%,20.00%,40.00%,80.00%,92.00%,85.00%, 79.17% in NC,CC,CCA,CINⅠ,CINⅡ,CINⅢand SCC tissues,respectively. And the expression degree was significance difference in multiple comparison among CINⅠand CINⅡ,CINⅢ,SCC group(P<0.01).③The expression rate of P16INK4a was 0%, 10.00 % , 33.33 % , 72.00 % , 88.00 % ,90.00 % and 95.83 % in NC,CC,CCA,CINⅠ,CINⅡ,CINⅢand SCC tissues,respectively. The expression degree of P16INK4a was significantly higher in SCC group than in CINⅡgroup(P<0.01).④The expression rate of COX-2 was 0%, 10.00%, 13.33%, 68.00%,84.00% ,95.00 % and 100.00 % in NC,CC,CCA,CINⅠ,CINⅡ,CINⅢand SCC tissues,respectively. There was significantly different between the CINⅠgroup and CINⅢ,SCC groups(P<0.05). The expression degree was significance difference in multiple comparison among CINⅠand CINⅡ, CINⅢand SCC group(P<0.01).⑤The expression rate of Ki-67 was 10.00%, 30.00%, 46.66%, 76.00%, 96.00%,100.00% and 100.00% in NC,CC,CCA,CINⅠ,CINⅡ,CINⅢand SCC tissues, respectively. The expression rate of Ki-67 in CINⅡ,CINⅢ,SCC group was greater than in CINⅠgroup(P<0.05).The expression dgree of Ki-67 was significantly different between the CINⅠ,Ⅱgroup and CINⅢ,SCC group ( P < 0.05 ) .⑥The expressions of P16INK4a,COX-2 and Ki-67 were positively correlated with that of Survivin (P<0.05).There was statistical significance in correlational analyse between P16INK4a and Ki-67 (P<0.001).Conclusion:①Expression degrees of Survivin , P16INK4a,COX-2 and Ki-67 were increased with the transformation from CIN to SCC,which may be related to the oncogenesis and development of cervical tissue.②Overexpression of Survivin in CINⅡgroup was frequent events and it can be activated in early step of cervical carcinogenesis.③The expression of P16INK4a had positive correlation with ki67,which may play important roles in the cervical caricnogenesis.④The relations of P16INK4a,Ki-67 and COX-2 had no statistic significance, which suggests that there were multi-factors and multi-pathways to cause carcinogenesis of cervix.⑤The co-operative expression of Survivin, P16INK4a,COX-2 and Ki-67 could be a useful biomarker for early diagnosis of the SCC and CIN, which may be of potential value for clinical appplication.