p16/Ki-67细胞学双染在子宫颈癌筛查中应用价值  

Diagnostic value of p16/Ki-67 dual stain cytology for detection of cervical precancerous lesions

作　　者：刘玉艳[1] 沈久洋 朱安超[1] 秦丹婷 黄英[1] 

机构地区：[1]哈尔滨市第一医院病理科,150010

出　　处：《临床与实验病理学杂志》2017年第1期38-41,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨p16/Ki-67细胞学双染检测在子宫颈癌筛查中的应用价值。方法选取液基细胞学(thinprep cytologic test,TCT)检查结果为意义不明的非典型鳞状细胞(atypical squamous cells of undetermined significance,ASC-US)和低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)的患者295例,行p16/Ki-67细胞学双染检测、阴道镜检查、定位活检病理检查,比较p16/Ki-67细胞学双染与病理活检的符合率,并检测其在两组病例中的敏感性和特异性。结果在ASC-US和LSIL两组中,p16/Ki-67细胞学双染的阳性率分别为37.42%和36.36%;病理活检诊断子宫颈上皮内病变2/3(cervical intraepithelial neoplasia 2/3,CIN2/3)阳性率分别为25.77%和25.76%,两者具有较高的符合率。ASC-US组中,p16/Ki-67诊断CIN2/3病例的敏感性83.33%,特异性78.51%;LSIL组中,p16/Ki-67诊断CIN2/3病例的敏感性85.30%,特异性80.61%。结论 p16/Ki-67细胞学双染可提高TCT的敏感性和人类乳头瘤病毒(human papilloma virus,HPV)检测的特异性;p16/Ki-67细胞学双染检测有效分流TCT中宫颈高级别病变,提高子宫颈癌筛查的准确率。Purpose To investigate the diagnostic value of p16/Ki-67 dual stain cytology for detection of cervical precan- cerous lesions as a novel option for cervical lesions screening. Methods A total of 295 cases diagnosed as atypical squamous cells of undetermined significance （ASC-US） and low-grade squamous intraepithelial lesion （LSIL） from thinprep cytologic test （TCT） were selected. Double staining of p16/Ki-67 cytolo- gy, vaginal biopsy, biopsy and pathological examination were applicated, p16/Ki-67 dual stain cytology was compared with that of biopsy and pathological examination. At the same time, The sensitivity and specificity of p16/Ki-67 dual stain cytology between ASC-US and LSIL was analyzed. Results The positive rate of pl6/Ki-67 dual stain cytology were 37.42% and36. 36% in ASC-US and LSIL, respectively. The positive rate of cervical intraepithelial neoplasia 2/3 （ CIN2/3 ） were 25.77% and 25.76%. The sensitivity and specificity of the p16/Ki-67 test for detecting CIN2/3 was 83.33% and 78.51%. The sensi- tivity and the specificity of the p16/Ki-67 test for detecting CIN2/3 was 85.30% and 80. 61% in LSIL group. Conclusion p16/Ki-67 double stain cytology detection can improve the sensitivity of CIN2/3 and the specificity of human papilloma vi- res （HPV）. p16/Ki-67 double stain detection can effectively triage the high grade cervical lesions in TCT and improve the ac- curacy of cervical cancer screening.

关 键 词：p16/Ki-67 细胞学双染 液基细胞检测 

分 类 号：R737.9[医药卫生—肿瘤]