TCT结合DNA定量及Ki67 p16免疫组化联合对宫颈癌及其癌前病早期筛查的应用研究  

Application research of TCT DNA quantification combined with Ki67 P16 immunohistochemistry in screening cervical cancer and precancerous diseases

作　　者：郭周庆[1] 陈光辉[1] 吴又明[1] 王红霞[1] 莫和国[1] 邓文成[1] 李纳[1] 

机构地区：[1]南方医科大学附属小榄医院,中山528415

出　　处：《国际医药卫生导报》2015年第2期180-183,共4页International Medicine and Health Guidance News

基　　金：2013年度中山市医疗卫生类科技计划项目（20132A152）

摘　　要：目的评估液基细胞学（TCT）结合DNA定量分析及免疫组化（Ki67、P16）对宫颈上皮内瘤病变筛查的应用价值。方法对参预宫颈癌前病变筛查的妇女，同时进行液基细胞，DNA定量分析及免筛组化（Ki67、P16）方法学评估及临床应用价值探讨。结果液基细胞学筛查阳性率为11．63％，敏感性与特异性分别为81．28％、27．50％。DNA定量分析筛查阳性率为11．87％，敏感性及特异性分别为：89．83％、19．51％；TCT与DNA联合筛查阳性率为13．54％，敏感性及特异性分别为94．11％、15．36％。免疫组化（Ki67、P16）的阳性表达率分别为84％、56％，两者之间差异有统计学意义（P〈0．05）。结论液基细胞学结合DNA定量分析，再辅以免疫组化（Ki67、P16），不但可以提高筛查的阳性率、敏感性、特异性，而且可以了解宫颈癌及癌前病变各阶段的预后与转归，病变程度。更有利于早期诊断及早期治疗。Objective To evaluate the application value of thinprep cytologic test （TCT） combined with DNA quantitative analysis and immunohistochemistry （Ki67, P16） in screening cervical intraepithelial neoplasia. Methods Women participating in cervical premalignant screening received TCT, DNA quantitative analysis and immunohistochemistry （Ki67, P16）, then made methodological evaluation and clinical application value discussion. Results The positive rate of TCT screening was 11.63%, sensitivity and specificity were 81.28% and 27.50% respectively. The positive rate of DNA quantitative analysis screening was 11.87%, sensitivity and specificity were 89.83% and 19.51% respectively. The positive rate of TCT combined with DNA quantitative analysis screening was 13.54%, sensitivity and specificity were 94.11% and 15.36% respectively. The positive expression rate of immunohistochemistry （Ki67, P16） were 84% and 56% respectively, with statistically significant difference （P 〈 0.05）. Conclusion The combination ofTCT, DNA quantitative analysis and immunohistochemistry （Ki67, P16） can not only improve positive rate, sensitivity, specificity of screening, but also show more about the prognosis and turnover of cervical cancer and each precancerous stage, which is conducive to early diagnosis and early treatment.

关 键 词：液基细胞学 DNA定量分析 免疫组化 

分 类 号：R737.9[医药卫生—肿瘤]