阴道镜多点活检结合抑癌基因表达检测在 宫颈癌筛检中的意义

Significance of multiple punch biopsy under colposcopy and tumor suppressor gene expression in screeningof cervical cancer

摘要:

目的 探讨阴道镜多点活检结合PTEN和p27抑癌基因表达在宫颈癌筛检中的意义。方法 选择宫颈癌可疑患者113例进行阴道镜活检，采用免疫组化法对最终确诊为宫颈上皮内瘤样变及宫颈癌的病例进行PTEN和p27的基因表达检测。结果 阴道镜多点活检筛查的CINⅠ、CINⅡ、CINⅢ和CIS及ICC与最终病理诊断相比，符合率分别为71.4%、69.2%、60%及100%。CINⅠ、CINⅡ、CINⅢ和CIS、ICC中均存在PTEN、p27抑癌基因的阴性表达，两种基因的阳性表达率均随癌变进展逐渐下降，差异有显著性（P <0.05）。结论 阴道镜多点活检在宫颈癌筛检中具有一定的临床价值，但仍存在局限性，联合PTEN和p27抑癌基因表达率的检测可以提高筛查的准确率。

Abstract:

【Objective】 To investigate the significance of multiple punch biopsy under colposcopy and PTEN and p27 tumor suppressor gene expression in screening of cervical cancer. 【Methods】 113 possible cervical cancer patients were treated with multiple punch biopsy under colposcopy. PTEN and p27 gene expression was examined in those patients who were diagnosed with cervical intraepithelial neoplasia and cervical cancer by immunohistochemical staining. 【Results】 The screening accordance rates of CINⅠ,CINⅡ,CINⅢ&CIS,ICC by multiple punch biopsy under colposcopy and final pathology diagnosis were 71.4%, 69.2%, 60%, 100%, respectively. PTEN and p27 tumor suppressor gene negative expression existed inCINⅠ,CINⅡ,CINⅢ&CIS, ICC. The positive expression rates of two genes were all decreased with the development of cancer which Chi-square colposcopy can provide some clinic value in screening of cervical cancer, but this method still exist some limitation. The accuracy of screening can be improved if this method is combined with examination of PTEN and p27 tumor suppressor gene expression rates test all showed significant differences (P ＜0.05). 【Conclusion】 Multiple punch biopsy under.colposcopy can provide some clinical value in screening of cervical cancer, but this method still exist some limitation.The accuracy of screening can be improved if this method is combined with examination of PTEN and p27 tumor suppressor gene expression rates.