Expression And Clinical Significance Of P16 And Ki67 In Stage ⅠB1-ⅡA2 Cervical Adenocarcinoma

Objective:To investigate the expression levels of P16 and Ki67 in stage IB1-IIA2 cervical adenocarcinoma and both of relationship with clinicopathological characteristics,analyze the prognostic factors affecting stage IB1-IIA2 stage cervical adenocarcinoma,and explore the relationship and significance between P16 positive expression and high-risk HPV infection by a small sample.Methods:To Collect relevant clinical data of patients including a total of 145 cases after surgical treatment of IB1-IIA2 cervical adenocarcinoma(case group)and 75 cases of Cervical pathology diagnosis were normal cervical normal tissue and benign lesions(control group)in Shanxi Cancer Hospital from December 2012 to June 2017.First,SP immunohistochemistry was used to detect the expression of P16 and Ki67 in the two groups and ROC curves were drawn.Second,the chi-square test was used to analyze the relationship between the two and clinicopathological characteristics.Finally,the COX proportional hazard model was used to analyze the multifactorial factors affecting the prognosis of stage IB1-IIA2 cervical adenocarcinoma..In addition,46 patients with cervical adenocarcinoma with HPV information were selected and Spearman was used to analyze the correlation between P16 positive expression and high-risk HPV infection.Results:1.The expressions of P16 and Ki67 in the cervical adenocarcinoma group weresignificantly higher than those in the normal tissues and benign lesion groups,and the difference was statistically significant(P<0.05);however,the correlation between the expression of P16 and Ki67 was not yet considered(P>0.05).The combined detection of both has a high diagnostic value for cervical adenocarcinoma,with a sensitivity of87.6% and a specificity of 90.7%.In addition,the expression of P16 and Ki67 in differently differentiated tissues was significantly different(P<0.05).The expressions of P16 and Ki67 in poorly differentiated tissues were significantly higher than those in highly differentiated and moderately differentiated tissues.2.Follow-up of 145 patients with stage IB1-IIA2 cervical adenocarcinoma,the tumor-free survival rate was 86.2%,and the survival rate was 89.7%.Univariate analysis showed that the prognostic factors were clinical stage,lymphatic metastasis,vascular invasion,tumor diameter,and degree of differentiation(P<0.05).Multivariate analysis showed that clinical stage,lymphatic metastasis,and degree of differentiation had statistically significant effects on their prognosis(P<0.05),and could be the independent factor affecting the prognosis of patients with stage IB1-IIA2 cervical adenocarcinoma.3.Analysis of 46 cases of cervical adenocarcinoma showed that there was a correlation between P16 positive expression and high-risk HPV infection(P <0.05).In addition,the mortality rate of high-risk HPV infection and the P16-positive group was lower than that of the P16-negative group.The difference was statistically significant.Conclusions:The expression of P16 and Ki67 in stage IB1-IIA2 cervical adenocarcinoma were significantly higher than those in normal tissues and patients with benign lesions,suggesting that P16 and Ki67 may be closely related to the occurrence and development of cervical adenocarcinoma.In addition,the expression of P16 and Ki67 in low-differentiated tissues is significantly higher than that in highly-differentiated and moderately-differentiated tissues.Therefore,the high expression of P16 and Ki67 often reflects the higher the degree of malignancy,which can help make treatmentdecisions and have reference value for judging prognosis.Clinical stage,lymphatic metastasis,vascular invasion,tumor diameter,and degree of differentiation have significant effects on the prognosis of patients with stage IB1-IIA2 cervical adenocarcinoma.Among them,lymphatic metastasis,clinical stage,and degree of differentiation can be used as independent risk factors that affect their prognosis.Therefore,patients with high-risk factors such as lymphatic metastasis,low degree of differentiation,and late stage after cervical adenocarcinoma should supplement adjuvant therapy.Treatment has a positive effect on improving the prognosis of patients.