宫颈脱落细胞块及CINtec PLUS在ASC-US、LSIL和ASC-H患者分流中的意义  

Significance of cervical exfoliated cell block and CINtec PLUS in cervical cytology ASCUS,LSIL and ASC-H

作　　者：张波 岳振营[2] 杨志敏 南平[4] 徐滨[2] 董艳光[2] 胡营营[2] 李文雪[2] 孙晓辉 孙雪梅 ZHANG Bo;YUE Zhen-ying;YANG Zhi-min;NAN-Ping;XU Bin;DONG Yan-guang;HU Ying-ying;LI Wen-xue;SUN Xiao-hui;SUN Xue-mei(Department of Pathology,the Third Affiliated Hospital of Guangdong Medical University,Foshan 528000,China;Department of Pathology,the Central Hospital of Shengli Oilfield,Dongying,257000,China;Department of Pathology,the Fourth People’s Hospital,Nanhai District,Foshan City,Guang Foshan 528000,China;Department of Gynaecology,the Central Hospital of Shengli Olifeld,Dongying 257000,China)

机构地区：[1]广东医科大学附属佛山市顺德区龙江医院病理科,广东佛山528000 [2]东营市胜利油田中心医院病理科,山东东营257000 [3]佛山市南海区第四人民医院病理科,广东佛山528000 [4]东营市胜利油田中心医院妇科,山东东营257000

出　　处：《诊断病理学杂志》2020年第9期658-663,共6页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨数控标准化细胞块制备技术(NCS)下宫颈细胞块(CB) p16/Ki-67免疫细胞化学(CINtec PLUS)的染色及判读,同时探讨CINtec PLUS在意义不明确的非典型鳞状细胞(ASC-US)、低级别鳞状上皮内病变(LSIL)和不除外高度病变的不典型鳞状上皮细胞(ASC-H)患者中分流的意义。方法收集自然沉降液基薄层细胞学技术(LCT)诊断为ASC-US、LSIL、ASC-H患者共220例,以宫颈活检诊断为最终标准,将NCS用于CB制备中,探讨CB中CINtec PLUS染色及判读;同时采用敏感度、特异度、阳性预测值、阴性预测值同比LCT CINtec PLUS结果,评价CB CINtec PLUS的筛查效能。结果①220例LCT样本制备的CB诊断结果为:NILM 32例、ASC-US 77例、LSIL 57例、ASC-H 33例及HSIL 21例,CINtec PLUS在LCT同CB中的阳性率均与病变程度呈正相关;②本数据诊断为ASC-US、LSIL和ASC-H的病例中,CB的组织学阳性符合率92.2%(154/167)高于LCT 87.3%(192/220);③ASC-US、ASC-H样本中,CINtec PLUS在CB中的敏感度高于LCT。结论 CINtec PLUS在CB诊断ASC-US、ASC-H患者中的应用,有助于患者分流管理。Objective To study the staining and interpretation of p16/cell proliferation associated nuclear antigen(Ki-67) double-staining(CINtec PLUS) in cervical exfoliated numerical control standard cell block preparation technology,and to investigate the application value of CB CINtec PLUS staining in ASCUS,LSIL and ASC-H patient triage management. Methods 220 patient sample with ASCUS,LSIL and ASC-H were collected in the Third Affiliated Hospital of Guangdong Medical University and Shengli Oilfield Central Hospital. Pathological diagnosis of cervical biopsy was used as the final standard. The results of diagnostic tests were described by using the sensitivity,specificity,positive predictive value,negative predictive value,compared with the LCT CINtec PLUS staining result to evaluate the screening value of CINtec PLUS in cervical cell block. Results 220 CB patients samples included NILM(32 cases),ASC-US(77 cases),LSIL(57 cases),ASC-H(33 cases) and HSIL(21 cases). The positive rate of CINtec PLUS in LCT and CB was positively correlated with the degree of disease. The histologically positive coincidence rate of CB in the ASC-US,LSIL and ASC-H cases diagnosed in our data was 92. 2%(154/167) and higher than LCT 87. 3%(192/220). The sensitivity of CINtec PLUS in ASCUS and ASC-H CB cases was higher than that in LCT. Conclusion The application of CINtec PLUS in ASC-US,ASC-H CB patients is helpful for patients’ triage management.

关 键 词：数控标准化细胞块制备技术 CINtec PLUS 判读 

分 类 号：R446[医药卫生—诊断学]