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Objective To explore the positive expressions of P 16 and Ki -67 proteins in cervical biopsy lesions of patients with high-risk HPV infection and abnormal detection of liquid -based thin-layer cytology test (TCT),and the clinical value in predicting occurrence of early cervical cancer .Methods A total of 120 patients with high-risk HPV infection(16 and 18 subtypes positive) and abnormal TCT in the Traditional Chinese Medicine Hospital of Linhai from January 2016 to July 2017 were enrolled in the study.The colposcopy was used to get cervical biopsy lesions for pathological diagnosis ,immunohistochemical staining was used to detect P 16 and Ki-67 proteins. Results There were up to 66 patients with HPV-16 positive,34 cases with HPV-18 positive,other 20 cases with 16 and 18 positive;6 cases of atypical squamous epithelial cells (ASC),46 cases of low-grade squamous intraepithelial lesions (LSIL),60 cases of high-grade SIL(HSIL),other 8 cases of cervical squamous cell carcinoma (SCC) were diagnosed by TCT;5 cases of inflammation,105 cases of CIN and 10 cases of SCC by pathologically diagnosis.The positive rates of P16 and Ki-67 proteins were gradually increased in patients with inflammation ,CIN and SCC[0(0／5),36.2%(38／105),70.0%(7／10),χ2 ＝4.382,P＝0.036;0 (0／5),40.0%(42／105),80.0%(8／10),χ2 ＝5.945,P＝0.015].The patients with CIN were followed up for 21～36 months,median time 29.5 months.Twenty-six patients progressed to SCC ,at the end of follow-up,the positive rates of P16 and Ki-67 proteins in patients with SCC were significantly higher than those in the CIN patients without progress [61.5%(16／26) vs.39.2%(31／79), χ2 ＝3.934,P＝0.047;69.2%(18／26) vs.41.8%(33／79),χ2 ＝5.905,P＝0.015].Conclusion The positive expression rates of P16 and Ki-67 proteins in cervical biopsy tissues are significantly higher in patients with high -risk HPV infection and abnormal TCT ,which in patients with pathologically diagnosis of SCC are higher than CIN patients,the same results in CIN patients with SCC progression than non -progressing patients,suggesting that P16 and Ki-67 proteins are of great value in predicting occurrence of early cervical cancer .
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Objective To analyze the application of the HR -HPV,TCT combined with digital colposcopy cervical biopsy in diagnosis of CIN and cervical carcinoma.Methods From 2014 to 2016,250 cases diagnosed as ASCUS and above the level of disease were selected in Shanxi Cancer Hospital ,including 148 cases of ASCUS,68 cases of LSIL,27 cases of HSIL and 7 cases of SCC.The HR-HPV copy number was detected by using PCR fluorescence measurement,the Reid colposcopy scores were measured by using digital colposcopy ,and the cervical histopathological diagnosis was regarded as a measurement rule.Results The diagnostic rate of simple use of TCT for the diagnosis of CIN and above lesions was 41.20%(103/250), HR -HPV & TCT in diagnosis of CIN and above lesions was 58.78%(77/131),TCT & digital colposcopy for the diagnosis of CIN and above lesions was 67.42%(89/132), which were significantly increased (χ2＝35.87,P＝0.00;χ2＝59.01,P＝0.00).The diagnostic rate of HR-HPV&TCT combined with electronic colposcopy in diagnosis of lesions above CIN was 79.82%( 91/114 ), which was significantly higher than that of HR -HPV & TCT[58.78%(77/131)],and the diagnostic rate of TCT & digital colposcopy was 67.42%(89/132)(χ2＝15.54,P＝0.01;χ2＝8.05,P＝0.02).The incidence of CIN and cervical cancer were closely related with HR -HPV infection and the rate of HR-HPV infection showed an increasing trend with the aggravating degree of disease (the HR-HPV infection rate of ASCUS was 39.86%,the HR-HPV infection rate of LSIL was 61.76%,the HR-HPV infection rate of HSIL was 88.89%,while the HR-HPV infection rate of SCC was 100.00%).Conclusion HR-HPV,TCT combined with digital colposcopy can effectively improve the diagnosis rate of CIN and above the level of disease.At the same time,with the deterioration of the disease ,HR-HPV infection rate increases significantly ,which can provide diagnostic information and significance in the clinical diagnosis of CIN and cervical cancer.