肿瘤标志物、抑癌基因P16和HPV-L1蛋白检查在宫颈癌和癌前病变诊断中的意义  

Significance of tumor markers,antioncogene P16 and HPV-L1 in diagnosing cervical cancer and precancerous lesions

作　　者：刘小艳[1] 安莹花[1] 王娜 张云云 LIU Xiao-yan;AN Ying-hua;WANG Na;ZHANG Yun-yun(Department of Blood Transfusion,Baoji Maternal and Child Health Hospital,Baoji 721000,China;Department of Pathology,Baoji Hospital Affiliated to Xi'an Medical College,Baoji 721000,China;Department of Blood Transfusion,Baoji Hospital Affiliated to Xi'an Medical College,Baoji 721000,China)

机构地区：[1]陕西省宝鸡市妇幼保健院输血科 [2]陕西省西安医学院附属宝鸡医院病理科,宝鸡721000 [3]陕西省西安医学院附属宝鸡医院输血科,宝鸡721000

出　　处：《中国肿瘤临床与康复》2020年第4期448-451,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨糖类抗原(CA)153、CA125、P16基因和人乳头瘤毒(HPV)-LI在宫颈癌和癌前病变中的诊断意义。方法选取2016年1月至2019年1月间宝鸡市妇幼保健院收治的行宫颈液基细胞学(TCT)联合HPV检测的78例宫颈癌患者,根据检查结果分为宫颈癌组(32例)和宫颈上皮内瘤变组(CIN组,46例),并选取78例体检正常女性作为对照组。采用电化学发光免疫分析法检测三组受检者血清中的CA153和CA125水平,并用免疫组化染色法检测P16和HPV-L1蛋白水平,分析CA153、CA125、P16和HPV-L1在宫颈癌和癌前病变中的诊断价值。结果三组受检者的CA153和CA125水平比较,差异均有统计学意义(均P<0.05),且宫颈癌组患者、CIN组患者及对照组受检者的CA153和CA125水平均依次减少,差异均有统计学意义(均P<0.05)。三组受检者的CA153、CA125、P16和HPV-L1阳性率比较,差异均有统计学意义(均P<0.05),且宫颈癌组患者、CIN组患者及对照组受检者的CA153、CA125、P16和HPV-L1阳性率均依次减少,差异均有统计学意义(均P<0.05)。CA153、CA125、P16和HPV-L1单项诊断宫颈癌及癌前病变的敏感度和特异度均较低,四项联合诊断的敏感度和特异度较高。结论CA153、CA125、P16和HPV-L1联合检测可提高宫颈癌和癌前病变的诊断敏感度和特异度,值得临床推广使用。Objective To explore the diagnostic significance of CA153,CA125,antioncogene P16 and human papillomavirus(HPV)-L1 for cervical cancer and precancerous lesions.Methods From January 2016 to January 2019,78 patients who underwent cervical liquid-based cytology(TCT)combined with HPV detection at Baoji Maternal and Child Health Hospital were selected as subjects.According to the test results,they were divided into the cervical cancer group(32 patients)and the cervical intraepithelial neoplasia group(CIN group,46 patients),and another 78 healthy women who had physical examination were selected as a control group.The serum levels of carbohydrate antigen 153(CA153)and 125(CA125)were detected by electrochemiluminescence(ECL)immunoassay.The levels of P16 and HPV-L1 protein were detected by immunohistochemical staining.The diagnostic value of CA153,CA125,P16 and HPV-L1 for cervical cancer and precancerous lesions was analyzed.Results There were significant differences in the levels of CA153 and CA125 among the three groups,and the CA153 and CA125 levels were highest in the cervical cancer group followed by the CIN group and the control group(all P<0.05).There were significant differences in the positive expression rate of CA153,CA125,P16,and HPV-L1 among the three groups with the highest level in the cervical cancer group followed by the CIN group and the control group(all P<0.05).The sensitivity and specificity was low for single CA153,CA125,P16,and HPV-L1 and high for the combined diagnosis of the four.Conclusion Combined detection of CA153,CA125,P16 and HPV-L1 can improve the diagnostic sensitivity and specificity for cervical cancer and precancerous lesions,which is worthy of clinical application.

关 键 词：CA153 CA125 P16 HPV-L1 宫颈肿瘤 癌前病变 

分 类 号：R737.33[医药卫生—肿瘤]