P16 And P53 In High-grade Squamous Intraepithelial Lesion Expression And Clinical Significance

Background: Cervical cancer is the most common malignant tumor of female reproductive system,it is the second cause of death in women malignant tumors worldwide.Cervical malignancy is the only preventable tumor of which the mechanism can be clearly determined.Which occurred in cervical lesions,is closely related to cervical cancer is the cervical intraepithelial neoplasia(CIN).CIN can be divided into three levels according to the lesion degree(CIN I,CIN II and CIN III).CIN is divided into two categories according to the common clinical classification based on the assessment of cancer risk: the low-grade squamous intraepithelial neoplasia(LSIL)and the high-grade squamous intraepithelial neoplasia(HSIL).Most of the low-grade squamous intraepithelial neoplasia is natural fade,and high-grade squamous intraepithelial neoplasia is a cancerous potential.CIN I is usually included in LSIL;while CIN II and CIN III are classified into HSIL.There were significant differences between the treatment and prognosis for LSIL and HSIL in the clinic,respectively.The selection of treatment for LSIL and HSIL differs greatly.Therefore,clear pathological diagnosis is the cornerstone of reasonable treatment.The pathological diagnosis of CIN I,CIN II and CIN III can be easily affected by the subjective factors from pathologists.As a result,it is difficult to strictly divide these three levels,which increases the difficulty of diagnosis and treatment.In order to reduce the lack of reproducibility among different pathologists,a variety of biochemical markers were introduced,among which P16 and P53 have been widely applied in the clinic.If a pathologist cannot make a definite diagnosis in the process of identifying CIN disease by conventional HE staining,immunohistochemical staining(P16 or P53)can be used for morphological diagnosis.This study is to observe the expression of P16 and P53 in HSIL and illustrate the significance of these two markers for pathological tissues.Objective:This study is to observe the expression of P16 and P53 in HSIL,understand the relationship between the expression level of P16 and P53 with CIN II and CIN III,illustrate the role and significance of these two markers in the diagnosis of HSIL,and study whether there is a correlation between P16 and P53 to provide reliable evidence for clinical application of these indicators.Methods: Patients of cervical lesions treated in the First Affiliated Hospital of China Medical University from August 2009 to August 2015 were selected as the research subjects.Two subgroups was established according to the histological diagnosis results,including: 120 cases of CIN II,referred to as the Group A;56 cases of CIN III,referred to as the Group B;and 40 cases of non-cervical lesions were selected as the control group(all patients' cervical histopathological examination showed CIN negative).Immunohistochemical SP method was utilized to detect the expression of P16 and P53 proteins.Results: 1.Expression of P16 in HSIL: In the control group,the difference of positive expression rates of P16 in CIN II and CIN III was statistically significant(P<0.05).Moreover,in the control group,the expression of P16 in CIN II and CIN III increased gradually.According to the Spearman correlation analysis,the correlation coefficient was 0.525(P<0.05),indicating that the positive expression of P16 was correlated with the degree of cervical lesions.2.Expression of P53 in HSIL: In the control group,the difference of positive expression rates of P53 in CIN II and CIN III was statistically significant(P<0.05).Moreover,in the control group,the expression of P53 in CIN II and CIN III increased gradually.According to the Spearman correlation analysis,the correlation coefficient was 0.500(P<0.05),indicating that the positive expression of P53 was correlated with the degree of cervical lesions.3.Analysis on the co-expression and correlation of P16 and P53 in HSIL:According to detailed collation and analysis on the co-expression of P16 and P53 in specific situations,it is suggested that P16 and P53 correlation with each other in HSIL,indicating that these two indicators are have close correlation.Conclusions: 1.The positive expression rate of P16 in HSIL was significantly higher than that of healthy people.With the aggravation of the disease,the positive expression rate of P16 was significantly increased.The positive expression rate of P16 in HSIL was positively correlated with the CIN clinical classification.2.The positive expression rate of P53 in HSIL was significantly higher than that of healthy people.With the aggravation of the disease,the positive expression rate of P53 was significantly increased.The positive expression rate of P53 in HSIL was positively correlated with the CIN clinical classification.3.P16 and P53 correlation with each other in HSIL,indicating that these two indicators are have close correlation.The combined application of P16 and P53 has an important significance for the screening and grading diagnosis and treatment of CIN patients.