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目的探讨子宫颈组织中EZH2表达预测宫颈高级别病变的准确性。方法应用免疫组化S-P法检测正常宫颈、慢性宫颈炎、CINⅠ、CINⅡ、CINⅢ、宫颈癌各30例宫颈组织中EZH2的表达水平,所有选取标本术前均行高危人乳头瘤病毒分型(HPV DNA)检测。以组织病理学检查为金标准,比较EZH2检测和高危HPV DNA检测预测宫颈高级别病变的准确性。结果正常宫颈、慢性宫颈炎、CINⅠ、CINⅡ、CINⅢ、宫颈癌患者宫颈组织中EZH2阳性表达率分别为13.3%、16.7%、26.7%、63.3%、90.0%、93.3%,通过Spearman相关分析显示宫颈组织中EZH2阳性表达率与其组织学病变呈正相关(r=0.641,P<0.05)。EZH2检测宫颈高级别病变的预测灵敏度(Sen)、预测特异度(Spe)、阳性预测值(Pv+)、阴性预测值(Pv-)、准确性分别为82.2%、81.1%、81.3%、82.0%、81.7%,高危HPV DNA(HC2)检测的Sen、Spe、Pv+、Pv-、准确性分别为87.8%、57.7%、67.5%、82.5%、72.8%。结论 EZH2检测预测宫颈高级别病变的特异度、阳性预测值和准确性优于高危HPV检测,EZH2检测具有预测宫颈高级别病变的价值。
Objective To investigate the accuracy of EZH2 expression in cervical tissue for predicting high-grade cervical lesions. Methods Immunohistochemical SP method was used to detect the expression of EZH2 in 30 cases of normal cervix, chronic cervicitis, CINⅠ, CINⅡ, CINⅢ and cervical cancer. All the selected specimens were examined by high risk human papillomavirus type DNA) test. Histopathological examination as the gold standard, compared with EZH2 test and high-risk HPV DNA test to predict the accuracy of high-grade cervical lesions. Results The positive rates of EZH2 in normal cervix, chronic cervicitis, CINⅠ, CINⅡ, CINⅢ and cervical cancer were 13.3%, 16.7%, 26.7%, 63.3%, 90.0% and 93.3% respectively. Spearman correlation analysis showed that cervical The positive expression rate of EZH2 in tissues was positively correlated with histological changes (r = 0.641, P <0.05). The predictive sensitivity (Spe), positive predictive value (Pv +) and negative predictive value (Pv-) of EZH2 in detecting high-grade cervical lesions were 82.2%, 81.1%, 81.3% and 82.0% , 81.7%, respectively. The accuracy of Sen, Spe, Pv + and Pv- detected by high-risk HPV DNA (HC2) was 87.8%, 57.7%, 67.5%, 82.5% and 72.8%, respectively. Conclusion The specificity of EZH2 in predicting high grade cervical lesions is better than that in high risk HPV. The positive predictive value and accuracy of EZH2 is superior to that of high risk HPV. EZH2 has the value of predicting high grade cervical lesions.