【摘要】 目的 探究细胞角蛋白7 (cytokeratin7,CK7)在宫颈癌及癌前病变中的表达及临床意义。方法 选取2017年1月至2023年4月在甘肃省妇幼保健院就诊疑似宫颈病变患者的存档病理蜡块及其相关的病历资料,其中包括正常宫颈鳞状上皮100例(正常组)、宫颈鳞癌100例(宫颈鳞癌组)、宫颈低级别鳞状上皮内病变(low-grade squamous intraepithelial lesions,LSIL) 100例(LSIL组)、宫颈高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL) 100例(HSIL组)、宫颈腺癌50例(宫颈腺癌组)。使用免疫组织化学方法检测各组p16、Ki-67和CK7的表达情况,分析其对宫颈癌与癌前病变的诊断价值和对LSIL与HSIL的鉴别价值,并比较宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅱ级及CINⅢ级、高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染及非感染患者的p16、Ki-67和CK7表达情况。结果 五组p16、Ki-67和CK7阳性表达率比较差异均有统计学意义(均P <0.05);宫颈鳞癌组、宫颈腺癌组、HSIL组、LSIL组的p16、Ki-67和CK7阳性表达率均显著高于正常组(均P<0.05),宫颈鳞癌组、宫颈腺癌组的p16、Ki-67和CK7阳性表达率均显著高于HSIL组、LSIL组(均P <0.05),HSIL组的p16、Ki-67和CK7阳性表达率均显著高于LSIL组(均P <0.05);p16、Ki-67和CK7表达联合检测诊断宫颈癌及癌前病变的曲线下面积(the area under curve,AUC)均显著大于各指标单独检测(均P<0.05)。p16、Ki-67和CK7表达联合检测鉴别LSIL与HSIL的AUC均显著大于各指标单独检测(均P<0.05);CINⅡ级和CINⅢ级患者的p16、Ki-67和CK7阳性表达率比较差异均无统计学意义(均P>0.05);HR-HPV感染组的p16、Ki-67和CK7阳性表达率均显著高于非感染组(均P<0.05)。结论 CK7在宫颈癌及癌前病变患者中多呈现阳性表达现象,其与p16、Ki-67联合检测对宫颈癌及癌前病变具有诊断价值,且HR-HPV感染可促进CK7阳性表达。更多还原

【Abstract】 Objective To explore the expression and clinical significance of cytokeratin 7(CK7) in cervical cancer and precancerous lesions.Method The archived pathological wax blocks and related case data of patients with cervical lesions in Gansu Maternal and Child Health Care Hospital were collected from January 2017 to April 2013.Among the patients,there were 100 cases with normal cervical squamous epithelium(normal group),100 cases with cervical squamous cell carcinoma(cervical cancer group),100 cases with low-grade squamous intraepithelial lesions(LSIL group),100 cases with high-grade squamous intraepithelial lesions(HSIL group) and 50 cases with cervical adenocarcinoma(cervical adenocarcinoma group).The expressions of p16,Ki-67 and CK7 were detected by immunohistochemistry.Their diagnostic value for cervical cancer and precancerous lesions,and the differential value for LSIL,and HSIL were analyzed.The expressions of p16,Ki-67 and CK7 between patients with cervical intraepithelial neoplasia(CIN)at grade Ⅱ and grade Ⅲ,and patients with high-risk human papilloma virus(HR-HPV) infection and those without infection were compared.Result There were significant differences in positive expression rates of p16,Ki-67 and CK7 among the five groups(all P <0.05).The positive expressions of p16,Ki-67 and CK7 in cervical cancer group,cervical adenocarcinoma group,HSIL group and LSIL group were significant higher than those in normal group(all P <0.05).The positive expression rates of p 16,Ki-67 and CK7 in cervical cancer group and cervical adenocarcinoma group were significant higher than those in HSIL group and LSIL group(all P <0.05).The positive expression rates of p16,Ki-67 and CK7 in HSIL group were significant higher than those in LSIL group(all P <0.05).Area under the curve(AUC) of p16 combined with Ki-67 and CK7 in the diagnosis of cervical cancer and precancerous lesions was significant greater than that of single index alone(all P <0.05).AUC of p16 combined with Ki-67 and CK7 in the differential diagnosis value of LSIL and HSIL was significant greater than that of single index alone(all P <0.05).There was no significant difference in positive expression rates of p16,Ki-67 and CK7 between patients at grades CIN Ⅱ and CIN Ⅲ(all P> 0.05).The positive expression rates of p16,Ki-67 and CK7 in HR-HPV infection group were significant higher than those in non-infection group(all P <0.05).Conclusion CK7 is positively expressed in most patients with cervical cancer and precancerous lesions.The combined detection of CK7,p16 and Ki-67 has diagnostic value for cervical cancer and precancerous lesions.And HR-HPV infection can promote CK7 positive expression.更多还原