细胞免疫化学p16/Ki-67双染结合DNA倍体分析预测HSIL的研究  

Study on immunocytochemistry p16/Ki-67 double staining combined with DNA ploidy analysis for analyzing and predicting cervical high grade squamous intraepithelial lesion

作　　者：张金秋[1] 朱萍[1] 陆敏华[1] 董建峰[1] 印永祥[1] 赵华[1] Zhang J inqiu Zhu Ping Lu Minhua Dong Jian feng Yin. Yongxiang Zhao Hua(Department of Pathology ,Affiliated Wuxi Municipal Maternal and Child Health Care Hospital, Nanjing Medical University ,Wuxi ,Nanjing 214002 ,China)

机构地区：[1]南京医科大学附属无锡市妇幼保健院病理科,江苏无锡214002

出　　处：《重庆医学》2017年第13期1770-1772,共3页Chongqing medicine

基　　金：江苏省无锡市卫计委妇幼健康成果技术推广项目(FYTG2016-2);江苏省无锡市卫生计生科技成果和适宜技术推广项目(T201645)

摘　　要：目的探讨DNA倍体分析联合细胞免疫化学p16/Ki-67双染检测对宫颈高级别鳞状上皮内病变(HSIL)及宫颈鳞癌(SCC)的诊断价值。方法随机收集细胞学检查73例,其中有少量DNA倍体异常细胞53例,DNA倍体阴性20例,通过细胞免疫化学双染检测p16/Ki-67结果。以病理结果为金标准,对比分析DNA倍体分析和DNA倍体分析联合p16/Ki-67双染对HSIL+的诊断价值。结果 20例DNA倍体阴性的标本中p16/Ki-67双染结果全部阴性。DNA倍体分析对HSIL+的阳性预测值为34.62%,DNA倍体分析联合p16/Ki-67双染对HSIL+的敏感性为84.62%,特异性为92.31%,阳性预测值为78.57%,阴性预测值为94.74%,明显高于DNA倍体分析对HSIL+的阳性预测值(P<0.05)。结论 p16/Ki-67双染可以明显提高HSIL检出的预测值,DNA倍体分析联合p16/Ki-67双染是预测HSIL+的有效方法,适合在医疗资源缺乏的地区实施。Objective To investigate the diagnostic value of DNA ploidy analysis combined with immunocytochemistry p16/ ki-67 double staining in cervical high grade squamous intraepithelial neoplasia（HSIL） and cervical squamous cell carcinoma（SCC）. Methods A total of 73 cases of cytological tests were randomly collected. Among them, 53 cases were small DNA ploidy abnormal cells and 20 cases were DNA ploidy negative. The p16/Ki-67 results were detected by immunocytochemistry double staining. With the pathological results as the golden standard, the diagnostic values of DNA ploidy analysis and DNA ploidy analysis combined with p16/Ki-67 double staining in HSIL ＋ was contrastively analyzed by pathologic results. Results Among 20 samples of DNA ploidy negative,the p16/Ki-67 double staining results all were negative. The positive predictive value of DNA ploidy analysis for HSIL ＋ was 34.62%. The sensitivity of DNA ploidy analysis combined with p16/Ki-67 double staining for HSIL＋ was 84.62%, and its specificity was 92.31%, the positive predictive value was 78.57 % and the negative predictive value was 94.74%, which were significantly higher than those of DNA ploidy analysis（P〈0.05）. Conclusion p16/Ki-67 double staining can significantly im- prove the prediction value of HSIL. The DNA ploidy analysis combined with p16/Ki-67 double staining is an effective method for predicting HSIL ＋ ,which is suitable for the implementation in the areas with lack of medical resources.

关 键 词：宫颈上皮内瘤样病变 p16/Ki-67双染 细胞免疫化学 DNA倍体分析 

分 类 号：R737.33[医药卫生—肿瘤]