Krt7和p16在宫颈病变进展中的临床意义

发布时间：2018-03-11 20:11

  本文选题：宫颈病变　切入点：Krt7　出处：《石河子大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨Krt7和p16在宫颈病变进展和临床诊治中的意义。方法:收集41例慢性宫颈炎、30例宫颈低级别鳞状上皮内病变(Low-grade Squamous Intraepithelial Lesion,LSIL)、44例宫颈高级别鳞状上皮内病变(High-grade Squamous Intraepithelial Lesion,HSIL)和25例宫颈癌的石蜡标本及临床资料,免疫组织化学法检测石蜡组织中Krt7和p16的表达,统计分析Krt7和p16的表达与慢性宫颈炎、LSIL、HSIL和宫颈癌的相关性。结果:Krt7在慢性宫颈炎、LSIL、HSIL和宫颈癌中的阳性表达率呈现逐渐递增的趋势,依次为24%(10/41)、13%(4/30)、71%(31/44)、88%(22/25),差异具有统计学意义(P0.05);Krt7阳性表达率在LSIL与HSIL、LSIL与宫颈癌、HSIL与宫颈癌之间存在统计学差异(P0.001),但在慢性宫颈炎与LSIL之间没统计学差异(P=0.251);p16在慢性宫颈炎、LSIL、HSIL和宫颈癌中的阳性表达率呈现逐渐递增的趋势,依次为39%(16/41)、60%(18/30)、88.6%(39/44)、100%(25/25),差异具有统计学意义(P0.05);p16阳性表达率在慢性宫颈炎与LSIL,LSIL与HSIL,LSIL与宫颈癌,HSIL与宫颈癌之间均存在统计学差异(P0.001);Krt7和p16均阳性表达者在慢性宫颈炎、LSIL、HSIL、宫颈癌中的比例分别为2.44%(1/41)、10%(3/30)、68.18%(30/44)、88.00%(22/25),差异具有统计学意义(P0.05)。检测Krt7、p16及联合检测Krt7和p16诊断宫颈病变的ROC曲线下面积分别为0.75、0.70、0.81(P0.001)。结论:Krt7表达阴性的LSIL,进展为HSIL或宫颈癌的风险可能较低,无需临床过多干预治疗;Krt7表达阳性的LSIL进展成HSIL或宫颈癌的风险可能较高,应当引起临床重视;联合检测Krt7和p16,可能在临床中能更有效的筛选出进展为HSIL的高危人群。
[Abstract]:Objective: to investigate the clinical significance of Krt7 and p16 in cervical lesions. Methods: High-grade Squamous was collected from 41 cases of chronic cervicitis and 30 cases of low grade squamous intraepithelial lesions of cervix. Intraepithelial Lesionhsl) and 25 cases of cervical cancer, paraffin wax specimens and clinical data, Immunohistochemical method was used to detect the expression of Krt7 and p16 in paraffin tissues. The correlation between the expression of Krt7 and p16 and the expression of HSIL in chronic cervicitis was analyzed. Results the positive rate of the positive expression of Krt7 and p16 in LSILIL and cervical cancer showed an increasing trend. The difference was statistically significant (P 0.05) between LSIL and HSILLSIL and cervical carcinoma (P 0.001), but there was no statistical difference between chronic cervicitis and LSIL. There was no significant difference between chronic cervicitis and chronic cervicitis. The positive expression rate in cancer is increasing gradually. The difference was statistically significant between chronic cervicitis and chronic cervicitis with positive expression rate of p0.05 and p16. There were significant differences between chronic cervicitis and LSIL and HSILLSIL and cervical cancer with HSIL and cervical carcinoma. The positive expression of Krt7 and p16 in patients with chronic cervicitis was higher than that in patients with chronic cervicitis and cervicitis with HSIL and HSIL. The ratio of positive expression of Krt7 and p16 was significantly higher in patients with chronic cervicitis than in patients with chronic cervicitis with positive expression of Krt7 and p16. There was a significant difference in the expression of p16 between chronic cervicitis and LSIL and HSIL. The cases were 2.44 / 41 / 1010 / 30 / 30 / 68.18 and 30 / 44 / 88.00 / 25 / 25, respectively. The difference was statistically significant (P 0.05). The area under the ROC curve for the detection of Krt7p16 and the combined detection of Krt7 and p16 for the diagnosis of cervical lesions was 0.750.700.81p0.001.Conclusion the risk of progression to HSIL or cervical cancer may be lower. The risk of progression to HSIL or cervical cancer of LSIL with positive expression of Krt7 may be higher without too much clinical intervention, which should be paid attention to in clinic. Combined detection of Krt7 and p16 may be more effective in screening high risk population for progression to HSIL.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

【参考文献】

相关期刊论文 前10条

1 罗丹霞;葛俊丽;赵丽莎;刘朵朵;陈必良;;HPV联合TCT在宫颈癌前病变筛查中的临床价值分析[J];中国生化药物杂志;2016年10期

2 秦英明;张秀菊;王维;岳丽;;TCT、HPV-DNA联合阴道镜检查在宫颈病变诊断中的应用价值[J];中国性科学;2016年07期

3 孙茂春;康晓琳;;HPV-DNA联合TCT检查对于诊断宫颈疾病的价值及其病理分型研究[J];中国妇幼健康研究;2016年05期

4 齐艳红;;宫颈病变筛查中宫颈液基薄层细胞学检查与HPVDNA检测的联合应用观察[J];山东医药;2016年19期

5 马琛;彭力;袁蔓丽;陈静;;TCT联合HPV-DNA及端粒酶检测在宫颈癌前病变筛查中的应用[J];检验医学与临床;2016年02期

6 熊炜;陈，

本文编号：1599709