P16/Ki-67双染联合DNA倍体分析在ASCUS分流诊断中的应用价值  

Value of P16/Ki-67 double staining combined with DNA ploidy analysis in ASCUS shunt

作　　者：尹璐 马成斌 刘平 张祎 赵学军 YIN Lu;MA Chengbin;LIU Ping;ZHANG Yi;ZHAO Xuejun(Department of Obstetrics and Gynecology,Changning Maternity and Child Healthcare Hospital of Shanghai,Shanghai 200051;Department of Pathology,Changning Maternity and Child Healthcare Hospital of Shanghai,Shanghai 200051,China)

机构地区：[1]上海市长宁区妇幼保健院妇产科,上海200051 [2]上海市长宁区妇幼保健院病理科,上海200051

出　　处：《癌变．畸变．突变》2020年第4期264-268,共5页Carcinogenesis,Teratogenesis & Mutagenesis

基　　金：上海市长宁区科学技术委员会项目(CNKW2016Y12)。

摘　　要：目的:探讨P16/Ki-67双染联合DNA倍体分析在宫颈意义不明的不典型鳞状细胞(ASCUS)分流诊断中的应用价值。方法:选取2016年12月—2018年8月上海市长宁区妇幼保健院收治的经液基细胞学(LCT)诊断为ASCUS的患者115例,同时行P16/Ki-67双染检测,DNA倍体分析,且以阴道镜病理活检结果为金标准。结果:115例患者阴道镜病理活检结果提示,宫颈上皮瘤变2级及以上(CIN2+)45例,其中CIN2级20例,CIN3级23例,鳞癌2例;P16/Ki-67双染检测CIN2+的灵敏性、特异性、诊断符合率分别为77.8%、77.1%、77.4%;DNA倍体分析检测CIN2+的灵敏性、特异性、诊断符合率分别为71.1%、34.3%、48.7%,且DNA倍体阴性的细胞标本中P16/Ki-67双染检测结果均为阴性;DNA倍体分析联合P16/Ki-67双染检测CIN2+的灵敏性、特异性、诊断符合率分别为92.9%、71.4%、86.3%,其中诊断符合率明显高于单纯采用DNA倍体分析(P<0.05)。结论:P16/Ki-67双染相较于DNA倍体分析检测CIN2+具有更高灵敏度和特异度,两者联合检测能有效提高准确率,可辅助用于ASCUS的分流诊断。OBJECTIVE:To investigate the value of P16/Ki-67 double staining combined with DNA ploidy analysis in the atypical squamous cells of undetermined significance(ASCUS)shunt.METHODS:The valid cytological samples from 115 patients diagnosed as ASCUS in Changning Maternity and Child Healthcare Hospital of Shanghai,from December 2016 to August 2018,were collected from LCT test.P16/Ki-67 double staining and DNA ploidy analysis were tested at the same time.The gold standard was the pathological biopsy results of colposcopy.RESULTS:Pathological examination showed that there were 45 cases of cervical intraepithelial neoplasia 2 or above(CIN2+),including 20 cases of CIN2,23 cases of CIN3 and 2 cases of squamous cell carcinoma.Among the 115 patients,the sensitivity,specificity and diagnostic coincidence rate of CIN2+by P16/Ki-67 double staining were 77.8%,77.1%and 77.4%,respectively;the sensitivity,specificity and diagnostic coincidence rate of CIN2+by DNA ploidy analysis were 71.1%,34.3%,48.7%,respectively,and the P16/Ki-67 double staining test results were negative in the DNA ploidy negative cell samples.DNA ploidy analysis combined with P16/Ki-67 double staining detection found that the sensitivity,specificity,and diagnostic coincidence rate of CIN2+were 92.9%,71.4%,86.3%,respectively,of which the diagnostic coincidence rate was significantly higher than that of DNA ploidy analysis alone(P<0.05).CONCLUSION:P16/Ki-67 double staining has higher sensitivity and specificity than DNA ploidy analysis for CIN2+.In addition,combination of the two methods effectively improved the accuracy for the shunt diagnosis of ASCUS.

关 键 词：P16/Ki-67双染 DNA倍体分析 不典型鳞状细胞 诊断价值 

分 类 号：R711.74[医药卫生—妇产科学]