陈丽珍 沈菲 李菁

[摘要] 目的 探討存活素（Survivin）、Ki67及人乳头状瘤病毒（HPV）16-E6联合检测在宫颈癌发生、发展中的作用机制。 方法 选择2018年1月至2020年12月我院收治的130例女性患者，其中正常对照组32例，低级别CIN组36例，高级别CIN组34例，宫颈癌组28例。所有患者均行免疫组化及流式细胞学检查。分析各组免疫组化检测结果、各组流式细胞检测结果，另分析各蛋白在宫颈癌表达中的相关性。 结果 宫颈癌组Survivin、Ki67及HPV16-E6蛋白阳性率均高于高级别CIN组及低级别CIN组，差异有统计学意义（P<0.05）;低级别CIN组、高级别CIN组与宫颈癌组Survivin、Ki67、HPV16-E6蛋白FI值比较，差异有统计学意义（P<0.05）;Survivin、Ki67相关性检验显示，r=0.534，一致性检验Kappa=0.512，P=0.006;Ki67及HPV16-E6蛋白相关性检验显示，r=0.714，Kappa=0.708，P=0.000;Survivin及HPV16-E6蛋白相关性检验显示，r=0.523，Kappa=0.627，P=0.001。 结论 Survivin、Ki67及HPV16-E6蛋白与宫颈癌发生及发展间存在密切联系，检测各指标进行宫颈癌早期筛查，利于尽早发现病变。

[关键词] 宫颈癌;宫颈上皮内瘤变;宫颈癌前病变;人乳头状瘤病毒;存活素;Ki67

[中图分类号] R737.33          [文献标识码] A          [文章编号] 1673-9701（2021）36-0009-04

Mechanism of action of Survivin， Ki67 and HPV16-E6 combined detection in occurrence and development of cervical cancer

CHEN Lizhen   SHEN Fei   LI Jing

Department of Obstetrics and Gynecology， the First People's Hospital of Jingdezhen City in Jiangxi Province， Jingdezhen   333000，China

[Abstract] Objective To explore the mechanism of action of combined detection of Survivin， Ki67 and human papillomavirus（HPV） 16-E6 in the occurrence and development of cervical cancer. Methods A total of 130 female patients who were admitted to our hospital from January 2018 to December 2020 were selected， including 32 patients in the normal control group， 36 patients in the low grade CIN group， 34 patients in the high grade CIN group and 28 patients in the cervical cancer group. All patients were examined by the immunohistochemistry and flow cytometry. Immunohistochemical results and flow cytometry results of each group were analyzed， and the correlation of each protein in the cervical cancer expression was analyzed. Results  The positive rates of Survivin， Ki67 and HPV16-E6 protein in cervical cancer group were higher than those in the high grade CIN group and the low grade CIN group， and the differences were statistically significant（P<0.05）. Survivin， Ki67 and HPV16-E6 protein FI values of the low grade CIN group， the high grade CIN group and the cervical cancer group were significantly different （P<0.05）. The Survivin and Ki67 correlation test showed r=0.534， the consistency test Kappa=0.512， P=0.006. The Ki67 and HPV16-E6 protein correlation test showed r=0.714， Kappa=0.708， P=0.000. The Survivin and HPV16-E6 protein correlation test showed r=0.523， Kappa=0.627， P=0.001. Conclusion Survivin， Ki67 and HPV16-E6 proteins are closely related to the occurrence and development of cervical cancer， and detection of these indicators is conducive to early detection of cervical cancer.

[Key words] Cervical cancer; Cervical intraepithelial neoplasia; Cervical precancerous change; Human papillomavirus; Survivin; Ki67

宫颈癌属妇科恶性肿瘤，其中人乳头状瘤病毒（Human papillomavirus，HPV）感染是宫颈癌发生的主要危险因素[1]。宫颈上皮内瘤变（Cervical intraepithelial neoplasias，CIN）属于宫颈癌前病变，若可尽早发现CIN，对宫颈癌预防具有重要作用[2-3]。存活素（Survivin）参与了多种血管因子的相互作用，可有效抑制血管内皮细胞凋亡及毛细血管的退化，在宫颈癌发生及发展中意义重大[4-5];Ki67抗原为非组蛋白，水平越高，肿瘤恶性程度越高，预后较差，反之，预后越好[6-7];临床依据HPV病毒基因区可分为多个区，E6作为多功能蛋白还可通过激活端粒酶使得正常细胞永生化，与其他蛋白存在相互作用[8-9]。……