p16INK4a和Ki-67免疫细胞化学染色在宫颈液基细胞学中的应用价值  

Evaluation of Ki-67 and p16INK4a immunocytochemistry in liquid-based cervical cytology

作　　者：杨彦华[1] 常宏[1] 于建宪[1] 纪萍[1] 姜长青[1] 

机构地区：[1]青岛市市立医院病理科

出　　处：《诊断病理学杂志》2009年第3期217-220,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨液基细胞学检测（LCT）剩余细胞学标本中p16INK4a、Ki-67的免疫细胞化学染色筛查宫颈鳞状细胞癌和宫颈癌前病变的价值。方法采用免疫细胞化学和免疫组化法对194例细胞学标本和91例组织活检标本进行p16INK4a、Ki-67检测。结果p16INK4a、Ki-67表达阳性率随着宫颈病变程度的加重而升高,与病变级别呈正相关。Ki-67的标记指数（LI）在HSIL组最高,与其他各组间均数的差异显著（P〈0.05）。LSIL及其以上病变细胞学p16INK4a和Ki-67与组织学诊断符合率分别为87.3%和80.95%。宫颈脱落细胞学Ki-67、p16INK4a的免疫细胞化学染色检出高级别病变及鳞癌病变的敏感度、特异度分别为83.6%、86.7%和87.1%、100%。结论利用LCT液基细胞学涂片中p16INK4a、Ki-67的免疫细胞化学染色作为辅助诊断指标应用于宫颈癌高危人群筛查,具有重要意义。Objective To explore the value of p16^INK4a and Ki-67 on residual cell specimens of LCT to screen cervical squamons carcinoma and preneoplastic lesions of the uterine cervix. Methods A total of 194 cytology specimens and 91 tissue samples were analyzed. Immunocytochemistry and immunohistochemistry were used to detect the expression of p16^INK4a and Ki-67 on exfoliated cells and the corresponding biopsies. Results The positive rates of p16^INK4a and Ki-67 both correlated with the degree of cervical neoplasia. HSIL group showed a significantly higher count of Ki-67 than did the other groups （P 〈 0.05）. The accordance of immunocytochemistry about Ki-67 and p16^INK4a and histological diagnosis were 87.30%（55x/63）and 80.95% （51/63） respectively on LSIL and higher grade lesions. The sensitivity and specificity of cervical exfoliative cells immanostaining for Ki-67 and p16^INK4ato detect high grade squamous intraepithehal lesion and squamous cell carcinoma were 83.6%, 86.7%, 87.1% and 100% respectively. Conclusion Immunocytochemistry of p16^INK4a and Ki-67 on LCT cytology specimens can be employed as a biomarker for screening patients at high risk of developing cervical carcinoma.

关 键 词：宫颈肿瘤 液基细胞学 免疫细胞化学 P16INK4A KI-67 

分 类 号：R737.33[医药卫生—肿瘤]