宫颈脱落细胞Ki67和exportin-5表达用于宫颈癌筛查的初步研究
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摘要
目的探讨宫颈脱落细胞中Ki67和exportin-5的表达用于宫颈癌筛查的价值。方法 3 000例同时行液基薄层细胞学检查(TCT)和杂交捕获Ⅱ代法人乳头瘤病毒(HPV HC-Ⅱ)检测的患者,按TCT结果分为4组,采用免疫荧光双标法检测各组宫颈脱落细胞中Ki67,实时荧光定量PCR检测exportin-5的表达情况。结果各组患者Ki67阳性率和exportin-5表达水平差异有统计学意义(P<0.01);NILM组、ASCUS/LSI组、ASC-H/HSIL组及SCC组患者的Ki67阳性率依次升高,exportin-5表达水平依次降低,两两之间差异均有统计学意义(P<0.01)。Ki67+exportin-5+TCT联合检测的灵敏度为93.12%,准确度为90.66%,均明显高于项目单独检测的效能值(P<0.01)。结论在宫颈癌细胞学检查结果恶化进展的病理进程中,宫颈脱落细胞中Ki67阳性表达率递进式升高,exportin-5的表达递进式下调,在TCT辅以Ki67、exportin-5三者联合检测具有较高的检测效能,对宫颈癌具有很大筛查价值。
Objective To investigate the value of Ki67 and exportin-5 expressions of cervical exfoliated cells in cervical cancer screening. Methods A total of 3 000 patients who underwent liquid-based thin-layer cytology(TCT) and hybrid capture II human papillomavirus(HPV HC-II) were divided into 4 groups according to TCT results. Ki67 in cervical exfoliated cells was detected by immunofluorescence double labeling while the expression of exportin-5 by real-time quantitative PCR. Results The positive rate of Ki67 and the expression of exportin-5 in each group were significantly different with other groups, and the differences were statistically significant(P<0.001). The Ki67 positive rate in NILM group, ASCUS/LSI group, ASC-H/HSIL group and SCC group increased and the expression of exportin-5 decreased in turn, and the difference between any two groups was statistically significant(P<0.01). The sensitivity, specificity and accuracy of Ki67+exportin-5+TCT were 93.12% and 90.66%, which were significantly higher than the individual performance values of each item(P<0.01). Conclusion In the pathological process of deterioration of cervical cancer cell carcinoma, the expression rate of Ki67 in cervical exfoliated cells is progressively increased, and the expression of exportin-5 is progressively down-regulated. The combined detection of TCT, Ki67 and exportin-5 has a high detection efficiency, which has great value for the screening of cervical cancer.
Objective To investigate the value of Ki67 and exportin-5 expressions of cervical exfoliated cells in cervical cancer screening. Methods A total of 3 000 patients who underwent liquid-based thin-layer cytology(TCT) and hybrid capture II human papillomavirus(HPV HC-II) were divided into 4 groups according to TCT results. Ki67 in cervical exfoliated cells was detected by immunofluorescence double labeling while the expression of exportin-5 by real-time quantitative PCR. Results The positive rate of Ki67 and the expression of exportin-5 in each group were significantly different with other groups, and the differences were statistically significant(P<0.001). The Ki67 positive rate in NILM group, ASCUS/LSI group, ASC-H/HSIL group and SCC group increased and the expression of exportin-5 decreased in turn, and the difference between any two groups was statistically significant(P<0.01). The sensitivity, specificity and accuracy of Ki67+exportin-5+TCT were 93.12% and 90.66%, which were significantly higher than the individual performance values of each item(P<0.01). Conclusion In the pathological process of deterioration of cervical cancer cell carcinoma, the expression rate of Ki67 in cervical exfoliated cells is progressively increased, and the expression of exportin-5 is progressively down-regulated. The combined detection of TCT, Ki67 and exportin-5 has a high detection efficiency, which has great value for the screening of cervical cancer.
引文
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[11] Deng XJ,Wu HG.The expression and its clinical significance of Ki67 and PTEN in ovarian serous tumor[J].Pract J Cancer,2011,26(4):365-371.
[12] 张若冰,杨凯云,谭慧,等.miR-126、miR-355及Exportin-5在肺癌中表达研究[J].实用医学杂志,2017,33(1):44-47.
[13] Monsonego J,Hudgens MG,Zerat L,et al.Risk assessment and clinical impact of liquid-based cytology,oncogenic human papillomavirus(HPV) DNA and mRNA testing in primary cervical cancer screening( the FASE study)[J].Gynecol Oncol,2012,125(1):175-180.
[14] Saslow D,Solomon D,Lawson HW,et al.American cancer society,American society for colposcopy and cervical pathology,and American society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer[J].Am J Clin Pathol,2012,137(4):516-542.
[15] Ikenberg H,Bergeron C,Schmidt D,et al.Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology:results of the PALMS study[J].J Natl Cancer Inst,2013,105(20):1550-1557.
[2] 王娇,舒丽莎,陈书玲,等.P16、Ki67 联合细胞学检查在宫颈脱落细胞中的诊断意义[J].中国妇幼保健,2016,31(10):2176-2179.
[3] WHO.Comprehensive cervical cancer prevention and control:a healthier future for girls and women[J].Geneva Switzerland WHO,2013,28(3):271-272.
[4] 单继烈,叶素梅,王兰英,等.液基薄层细胞学检测、高危型人乳头状瘤病毒- DNA 和人乳头状瘤病毒E6/E7 mRNA检测在宫颈癌早期筛查中的临床价值[J].中国卫生检验杂志,2018,28(6):667-669,672.
[5] 黄平,张雪,陈光元,等.p16、Ki67、PHH3和HPV-L1在宫颈脱落细胞中的表达及临床意义[J].海南医学,2016,27(21):3463-3466.
[6] 张佳佳,王萍.Scc、CA125 和 Ki67 在宫颈癌和癌前病变诊断中的价值[J].中国生物制品学杂志,2017,30(7):739-741.
[7] Du L,Schagenan JJ,Irnov,et al.MicroRNA expression distinguishes SCLC from NSCLL lung tumor cells and suggests a possible pathological relation between SCLCs and NSCLCs[J].EXP Cancer Res,2010,29(1):75-87.
[8] 沈小姣,于波,秦晓蕾.miRNA 在高危 HPV感染的宫颈组织中表达的意义[J].热带医学杂志,2016,16(11):1382-1385,1392.
[9] Liu Y,Zhou Y,Feng X,et al.Low expression of microrna- 126 is associated with poor prognosis in colorectal cancer[J].Genes Chromosomes Cancer,2014,53(4):358-365.
[10] Sehnal B,Driák D,Neumannová H,et al.Prevalence of anal human papillomavirus infection among women and its relation to cervical HPV infection[J].Ceska Gynekol,2012,77(3):210-214.
[11] Deng XJ,Wu HG.The expression and its clinical significance of Ki67 and PTEN in ovarian serous tumor[J].Pract J Cancer,2011,26(4):365-371.
[12] 张若冰,杨凯云,谭慧,等.miR-126、miR-355及Exportin-5在肺癌中表达研究[J].实用医学杂志,2017,33(1):44-47.
[13] Monsonego J,Hudgens MG,Zerat L,et al.Risk assessment and clinical impact of liquid-based cytology,oncogenic human papillomavirus(HPV) DNA and mRNA testing in primary cervical cancer screening( the FASE study)[J].Gynecol Oncol,2012,125(1):175-180.
[14] Saslow D,Solomon D,Lawson HW,et al.American cancer society,American society for colposcopy and cervical pathology,and American society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer[J].Am J Clin Pathol,2012,137(4):516-542.
[15] Ikenberg H,Bergeron C,Schmidt D,et al.Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology:results of the PALMS study[J].J Natl Cancer Inst,2013,105(20):1550-1557.