Role of p16, Ki-67 and human papilloma virus type in the shunt treatment of cervical intraepithelial neoplasiaII

Abstract

Objective To investigate the role of p16, Ki-67 and human papilloma virus (HPV) type in the shunt treatment of cervical intraepithelial neoplasia (CIN) Ⅱ. Methods The paraffin block on file and the pathological results from loop electrosurgical excision procedure (LEEP) of 377 CIN Ⅱpatients diagnosed with colposcope examination accompanied by cervical high-risk HPV infection in the Affiliated Hospital of Inner Mongolia Medical University of Obstetrics and Gynecology Department from January 2014 to October 2016 were collected. The paraffin sections were stained with p16 and Ki-67 immunohistochemistry. The correlation between the expression of p16 and Ki-67 in biopsy tissues and the pathological results after LEEP was analyzed. HPV type and pathological results after LEEP were also analyzed. Results LEEP postoperative pathological grade in 337 cases of CINⅡ patients was divided into two groups (<CINⅡ and ≥CINⅡ). There was no statistical difference in age between the two groups (t = 3.078, P = 0.063). There were statistical differences in the expressions of p16+ and Ki-67+ between the two groups [3.6% (8/233) vs. 88.5% (92/104), χ2 = 235.54, P < 0.001; 3.0% (7/233) vs. 76.9% (80/104), χ 2 = 197.63, P < 0.001]. There was a statistical difference in HPV infection type between the two groups (χ 2 = 12.713, P = 0.005). The sensitivity and specificity of p16+ and Ki-67+ for LEEP postoperative≥CINⅡ was 88.89% vs.77.78% and 95.96% vs. 95.80% respectively. There was a statistical difference in group type of p16 and Ki-67 in both groups (χ 2 = 304.28, P < 0.001). The sensitivity of p16+ Ki-67+ was 90.73% and the specificity was 98.74% in CINⅡ patients for LEEP postoperative. Conclusions The expressions of p16 and Ki-67 can guide the colposcopic biopsy for the treatment of CINⅡ. For CINⅡ patients with p16+ Ki-67+, the active treatment should be taken. Close observation needs to follow for p16 and Ki-67 single negative or double negative patients. Active treatment should be performed for CINⅡ patients with HPV16 type infection in CINII. Age can not be used as the basis for the patients with shunt CINⅡ. Key words: Uterine cervical neoplasms; Cervical intraepithelial neoplasia; Loop electrosurgical excision procedure; Genes, p16; Ki-67 antigen