p16/Ki67双染在宫颈病变检出中的作用  

Evaluation of p16/Ki67 dual-stained cytology for detecting cervical precancerous disease

作　　者：葛雪飞[1] 张睿怡 游珂[1] 郭艳利[1] 李子健[1] 耿力[1] GE Xuefei;ZHANG Ruiyi;YOU Ke;GUO Yanli;LI Zijian;GENG Li(Department of Obsteries and Gynecology, Peking University Third Hospital, Beijing, 100083)

机构地区：[1]北京大学第三医院,100083

出　　处：《中国计划生育学杂志》2017年第12期855-859,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨p16/Ki67双染在宫颈病变检出中的作用。方法:选取2017年1-5月期间在北京大学第三医院妇科门诊进行机会性筛查的92位妇女,比较p16/Ki67双染、液基细胞学检测(TCT)、高危人乳头瘤病毒(HR-HPV)检测分别在检出CIN2及以上病变的灵敏度、特异度、阳性似然比、阴性似然比、ROC曲线下面积(AUC)等指标,并进一步分析p16/Ki67双染分别在≥30岁妇女、HR-HPV阳性妇女中检出CIN2及以上病变的应用价值。结果:p16/Ki67双染检测检出CIN2及以上病变的灵敏度与HR-HPV、TCT相似(86.36%vs 84.85%vs 92.42%,P=1.000 P=0.424),特异度(76.92vs 30.77%vs 26.92%,P=0.001 P=0.001),AUC(0.816vs 0.578vs 0.597,P=0.001P<0.001)有统计学差异;≥30岁妇女组和HR-HPV(+)组有相似的结果。结论:p16/Ki67双染可提高检出CIN2及以上病变的特异度,具有更好的临床应用价值。Objective：To evaluate the clinical application of p16/Ki-67 dual staining in the diagnosis of cervical precancerous disease.Methods：A total of 92 women who were screened at Peking University Third Hospital from January2017 to May 2017 were recruited in this study.The sensitivity,specificity,positive and negative likelihood ratio,and the area under the ROC curve（AUC）in the detection of≥CIN2 lesions were compared among the p16/Ki67 dual-staining,TCT and HR-HPV for detecting cervical precancerous disease.The clinical value of p16/Ki-67 dual staining was further evaluated for the identification of≥ CIN2 lesions in women with positive HR-HPV or elder than 30 years old.Results：For detection of≥ CIN2 lesions,p16/Ki67 dual-staining had similar sensitivity when compared with TCT and HR-HPV（86.36% vs 84.85% vs 92.42%,P=1.000,P=0.424）,and specificity was significant higher than TCT and HR-HPV（76.92 vs 30.77% vs 26.92%,P=0.001,P=0.001）,AUC was also higher than TCT and HRHPV（0.816 vs 0.578 vs 0.597,P=0.001,P〈0.001）.Similar patterns were observed in the subgroup of women with positive HR-HPV or over than 30 years old.Conclusion：p16/Ki67 dual-staining can improve the specificity of diagnosing ≥CIN2 lesions,and has good clinical application value.

关 键 词：p16/Ki67双染 液基细胞学检测 人乳头瘤病毒 宫颈上皮内瘤变 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]