p16和Ki-67免疫细胞化学染色在宫颈ASCUS中的应用价值  

The Clinical Value of p16 and Ki-67 Immunocytochemical Stain in Cervical Atypical Squamous Cells Undefined Significance

作　　者：张建兰[1] 王夷黎[1] 禤坚艳[1] 柳晓春[1] 彭敏[1] 周东华[1] 

机构地区：[1]广东省佛山市妇幼保健院,广东佛山528000

出　　处：《实用妇产科杂志》2010年第4期293-295,I0001,共4页Journal of Practical Obstetrics and Gynecology

基　　金：广东省卫生厅医学研究基金(编号:A2009662)

摘　　要：目的:探讨液基薄层细胞学检测(TCT)剩余细胞学标本进行p16和Ki-67的免疫细胞化学染色,作为宫颈细胞学检查未明确诊断意义的不典型鳞状上皮细胞(ASCUS)中的分流管理的应用价值。方法:对2008年11月至2009年7月在佛山市妇幼保健院就诊的98例细胞学检查结果为ASCUS的患者进行p16、Ki-67免疫细胞化学染色检测,并与阴道镜下病理活检结果比较。结果:p16、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。p16在高级别鳞状上皮病变(HSIL)组和低级别鳞状上皮病变(LSIL)组中的阳性表达率与炎症组间比较,差异有统计学意义(P<0.05)。Ki-67在HSIL组中的阳性表达率与LSIL组和炎症组比较,差异有统计学意义(P<0.05)。p16和Ki-67的免疫细胞化学染色检出HSIL及鳞状细胞癌(SCC)的敏感度为83.3%(20/24)和91.7%(22/24);特异度为80.4%(74/92)和86.0%(74/86)。结论:利用TCT剩余细胞学标本进行p16和Ki-67的免疫细胞化学染色,是一种有效、简便的ASCUS分流管理的生物学标记物,可提高HSIL的检出率,使高危患者得到及时有效的治疗。Objective：To explore the relationship between p16,Ki-67 immunocytochemical stain and pathological classification in cervical atypical squamous cells undefined significance（ASCUS）in residual cell of thinprep liquid-based cytology test（TCT）.Methods：98 cases who suffering from ASCUS in TCT were collected in Foshan maternal and child health hospital from Nov,2008 to Jul,2009.And then the expressions of p16 and Ki-67 in the cervical cells were evaluated by immunocytochemical stain.The result was compared with the pathological result of colposcope biopsy.Results：The positive expression rate of p16,Ki-67 was raised accompanying with the severity of cervical disease,which was positively correlated with the degree of disease.There was statistical significant difference between the positive expression of p16 in HSIL and inflammatory groups,which was similar to LSIL（P0.05）.And the positive expression of Ki-67 in HSIL was significant difference compared with other groups（P0.05）.The sensitivity of p16 and Ki-67 was 83.3%（2024）,91.7%（2224）and the specificity was 80.4%（7492）,86.0%（7486）in immunochemistry stain.Conclusions：The detection of p16,Ki-67 via immunocytochemical stain in residual cells of TCT is an efficient and simple method to label the bio-marker in the administration of ASCUS,which can enhance the positive identification of HSIL and treat the high risk patient in time and effectively.

关 键 词：宫颈肿瘤 未明确诊断意义的不典型鳞状上皮细胞 液基细胞学检测 P16 KI-67 

分 类 号：R737.33[医药卫生—肿瘤]