P16/Ki-67细胞学双染在TCT诊断为非典型鳞状细胞意义不明确(ASC-US)中的分流作用研究  

Clinical Value of P16/Ki-67 Dual-stained Cytology for the Triage of Women with Atypical Squamous Cell of Undetermined Significance

作　　者：马钰[1] 李真真[1] 白旭升[1] 张巍 王彦芳[1] 荣晅[2] MA Yu;LI Zhen-zhen;BAI Xu-sheng;ZHANG Wei;WANG Yan-fang;RONG Xuan(Department of Pathology,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi,710068,China;Department of Gynecology,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi,710068,China)

机构地区：[1]陕西省人民医院病理科,陕西西安710068 [2]陕西省人民医院妇科,陕西西安710068

出　　处：《现代生物医学进展》2020年第1期123-126,共4页Progress in Modern Biomedicine

基　　金：陕西省自然科学基金项目(2015JQ8321).

摘　　要：目的:分析P16/Ki-67双染在TCT(Thinprep cytologic test)诊断为非典型鳞状细胞,意义不明确(Atypical Squamous Cells of Undetermined Significance,ASC-US)的患者分流中的作用。方法:选取2016年9月-2018年9月在我院经宫颈液基细胞学检查诊断为ASC-US的434例女性患者为研究对象,采用P16/Ki-67双染、高危型HPV(High-Risk human papillomavirus,HR-HPV)检测,对比二者与宫颈组织学活检结果的相关性,并分析二者在ASC-US患者分流中的作用。结果:P16/Ki-67细胞学双染法的敏感性为78.2%,特异性为79.2%,HR-HPV法的敏感性为33.5%,特异性为62.3%。P16/Ki-67细胞学双染法在年轻组患者中检出高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)及以上病变的敏感性为94.5%,特异性为85.7%;在年长组患者中敏感性为44.4%,特异性为74.3%。结论:P16/Ki-67细胞学双染作为一种临床应用简单、患者易于接受、价格相对低廉的生物学标志物,为宫颈癌的早期筛查提供了新的选择。同时,对于年轻患者,P16/Ki-67双染用于ASC-US的分流比HR-HPV检测具有更高的临床应用价值。Objective:To evaluate the clinical value of P16/Ki-67 cytology for triage of women with atypical squamous cell of undetermined significance(ASC-US).Method:A total of 434 cases diagnosed as ASC-US from Sep.2016 to Sep.2018 in our hospital were selected.Dual-stained cytology of P16/Ki-67,high-risk human papillomavirus(HR-HPV)detection,vaginal biopsy were applicated.P16/Ki-67 were compared with HR-HPV detected and pathological biopsy.Results:The sensitivity of P16/Ki-67 dual-stained was 78.2%,the specificity was 79.2%,The sensitivity of HR-HPV was 33.5%,the specificity was 62.3%,The sensitivity of P16/Ki-67 dual-stained in the group age under 35 years old was 94.5%,the specificity was 85.7%,in the group age above 35 years old,the sensitivity was 44.4%,the specificity was 74.3%.Conclusion:P16/Ki-67 dual-stained provides a new option for the early screening of cervical cancer,for simple clinical application,more acceptable and relatively inexpensive.Meanwhile,it has higher clinical application value than HR-HPV detection,especially in women under 35 years old.

关 键 词：P16/Ki-67细胞学双染 非典型鳞状细胞-意义不明确(ASC-US) 高危型人乳头状瘤状病毒(HR-HPV) 宫颈高级别鳞状上皮内病变(HSIL) 

分 类 号：R737.33[医药卫生—肿瘤]