高危型HPV分型、TCT、P16/Ki-67双染在宫颈癌筛查中的价值  

Clinical value of p16/ki 67 dual stained cytology of high-risk human papilloma virus for screening cervical cancer

作　　者：吴艳[1] 王瑾[1] 解浩然[1] 桑琳[1] WU Yan;WANG Jin;XIE Haoran;SANG Lin(Hefei Hospital Affiliated to Anhui Medical University,Hefei,Anhui Province,230000)

机构地区：[1]安徽医科大学附属合肥医院,230000

出　　处：《中国计划生育学杂志》2022年第12期2875-2879,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨高危型人乳头瘤病毒(HR-HPV)分型、液基薄层细胞学(TCT)和P16/Ki-67免疫化学双染在宫颈癌筛查中的临床应用价值。方法:回顾性收集2018年6月-2020年12月本院接受HR-HPV、TCT、P16/Ki-67双染检测以及阴道镜检查及宫颈活检的患者98例临床资料,比较不同检测方法与宫颈活检病理学结果的符合度。结果:细胞学P16/Ki-67免疫化学双染和TCT检测阳性率随着病变程度加重而逐渐升高(均P<0.05)。HPV16/18型感染患者中P16/Ki-67双染阳性率(72.3%)高于HPV其他12型感染阳性患者(34.3%)。HR-HPV、TCT、P16/Ki-67双染单独检测对HSIL+的诊断灵敏度分别为94.3%、62.3%和81.1%,特异度分别为29.0%、71.1%和84.4%。P16/Ki-67+HR-HPV+TCT联合检测筛查HSIL+的诊断准确度最高为86.7%,灵敏度84.9%、特异度88.9%。结论:HR-HPV以及TCT和P16/Ki-67免疫化学双染联合检测可提高宫颈癌筛查的准确率,降低宫颈病变的漏诊率和阴道镜转诊率,可为临床分流管理提供指导。Objective:To explore the clinical values of the type of high-risk human papilloma virus(HR-HPV),thinprep cytologic test(TCT),and P16/Ki 67 dual stained cytology for screening cervical cancer.Methods:The results of HR-HPV,TCT,P16/Ki 67 dual stained cytology,and colposcopy of 98 patients from June 2018 to June 2020 were:collected retrospectively,and the consistency between which and the pathological results of cervical biopsy of these patients were compared.Results:The positive rates of P16/Ki 67 dual stained cytology and TCT had increased gradually as the aggravation of cervical lesions of the patients(all P<0.05).The positive rates of P16/Ki 67 dual stained cytology(72.3%)of the patients with HPV16/18 infection was significantly higher than that(34.3%)of the patients with other 12 types of HPV infection.The sensitivity of HPV,TCT,and P16/Ki 67 dual stained cytology for diagnosing HSIL+of the patients were 94.3%,62.3%,and 81.1%,respectively,and the specificity of which were 29.0%,71.1%,and 84.4%,respectively.The highest accuracy,the sensitivity,and the specificity of P16/Ki 67 dual stained cytology,67+HR,and HPV+TCT for diagnosing HSIL+of the patients were 86.7%,88.9%,and 84.9%,respectively.Conclusion:The combined detection of HR-HPV,TCT,and P16/Ki 67 dual stained cytology of the patients can increase the accuracy of their cervical cancer screening,and reduce their missed diagnosis rate of cervical lesions and their referral rate to colposcopy,which can provide the guidance for shunting management in clinic.

关 键 词：宫颈癌筛查 高危人乳头瘤病毒分型 液基薄层细胞学 P16/Ki-67双染 效能 

分 类 号：R737.33[医药卫生—肿瘤]