本文選題：宮頸病變　切入點(diǎn)：Krt7　出處：《石河子大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討Krt7和p16在宮頸病變進(jìn)展和臨床診治中的意義。方法:收集41例慢性宮頸炎、30例宮頸低級別鱗狀上皮內(nèi)病變(Low-grade Squamous Intraepithelial Lesion,LSIL)、44例宮頸高級別鱗狀上皮內(nèi)病變(High-grade Squamous Intraepithelial Lesion,HSIL)和25例宮頸癌的石蠟標(biāo)本及臨床資料,免疫組織化學(xué)法檢測石蠟組織中Krt7和p16的表達(dá),統(tǒng)計(jì)分析Krt7和p16的表達(dá)與慢性宮頸炎、LSIL、HSIL和宮頸癌的相關(guān)性。結(jié)果:Krt7在慢性宮頸炎、LSIL、HSIL和宮頸癌中的陽性表達(dá)率呈現(xiàn)逐漸遞增的趨勢,依次為24%(10/41)、13%(4/30)、71%(31/44)、88%(22/25),差異具有統(tǒng)計(jì)學(xué)意義(P0.05);Krt7陽性表達(dá)率在LSIL與HSIL、LSIL與宮頸癌、HSIL與宮頸癌之間存在統(tǒng)計(jì)學(xué)差異(P0.001),但在慢性宮頸炎與LSIL之間沒統(tǒng)計(jì)學(xué)差異(P=0.251);p16在慢性宮頸炎、LSIL、HSIL和宮頸癌中的陽性表達(dá)率呈現(xiàn)逐漸遞增的趨勢,依次為39%(16/41)、60%(18/30)、88.6%(39/44)、100%(25/25),差異具有統(tǒng)計(jì)學(xué)意義(P0.05);p16陽性表達(dá)率在慢性宮頸炎與LSIL,LSIL與HSIL,LSIL與宮頸癌,HSIL與宮頸癌之間均存在統(tǒng)計(jì)學(xué)差異(P0.001);Krt7和p16均陽性表達(dá)者在慢性宮頸炎、LSIL、HSIL、宮頸癌中的比例分別為2.44%(1/41)、10%(3/30)、68.18%(30/44)、88.00%(22/25),差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。檢測Krt7、p16及聯(lián)合檢測Krt7和p16診斷宮頸病變的ROC曲線下面積分別為0.75、0.70、0.81(P0.001)。結(jié)論:Krt7表達(dá)陰性的LSIL,進(jìn)展為HSIL或?qū)m頸癌的風(fēng)險(xiǎn)可能較低,無需臨床過多干預(yù)治療;Krt7表達(dá)陽性的LSIL進(jìn)展成HSIL或?qū)m頸癌的風(fēng)險(xiǎn)可能較高,應(yīng)當(dāng)引起臨床重視;聯(lián)合檢測Krt7和p16,可能在臨床中能更有效的篩選出進(jìn)展為HSIL的高危人群。
[Abstract]:Objective: to investigate the clinical significance of Krt7 and p16 in cervical lesions. Methods: High-grade Squamous was collected from 41 cases of chronic cervicitis and 30 cases of low grade squamous intraepithelial lesions of cervix. Intraepithelial Lesionhsl) and 25 cases of cervical cancer, paraffin wax specimens and clinical data, Immunohistochemical method was used to detect the expression of Krt7 and p16 in paraffin tissues. The correlation between the expression of Krt7 and p16 and the expression of HSIL in chronic cervicitis was analyzed. Results the positive rate of the positive expression of Krt7 and p16 in LSILIL and cervical cancer showed an increasing trend. The difference was statistically significant (P 0.05) between LSIL and HSILLSIL and cervical carcinoma (P 0.001), but there was no statistical difference between chronic cervicitis and LSIL. There was no significant difference between chronic cervicitis and chronic cervicitis. The positive expression rate in cancer is increasing gradually. The difference was statistically significant between chronic cervicitis and chronic cervicitis with positive expression rate of p0.05 and p16. There were significant differences between chronic cervicitis and LSIL and HSILLSIL and cervical cancer with HSIL and cervical carcinoma. The positive expression of Krt7 and p16 in patients with chronic cervicitis was higher than that in patients with chronic cervicitis and cervicitis with HSIL and HSIL. The ratio of positive expression of Krt7 and p16 was significantly higher in patients with chronic cervicitis than in patients with chronic cervicitis with positive expression of Krt7 and p16. There was a significant difference in the expression of p16 between chronic cervicitis and LSIL and HSIL. The cases were 2.44 / 41 / 1010 / 30 / 30 / 68.18 and 30 / 44 / 88.00 / 25 / 25, respectively. The difference was statistically significant (P 0.05). The area under the ROC curve for the detection of Krt7p16 and the combined detection of Krt7 and p16 for the diagnosis of cervical lesions was 0.750.700.81p0.001.Conclusion the risk of progression to HSIL or cervical cancer may be lower. The risk of progression to HSIL or cervical cancer of LSIL with positive expression of Krt7 may be higher without too much clinical intervention, which should be paid attention to in clinic. Combined detection of Krt7 and p16 may be more effective in screening high risk population for progression to HSIL.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.33

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本文編號(hào)：1599709