液基脱落细胞学检查联合人乳头状瘤病毒、P16蛋白免疫组化染色检测在宫颈癌筛查中的价值分析  

Analysis of the Value of Thinprep Cytologic Test Combined with Human Papilloma Virus and P16 Protein Immunohistochemical Staining in Cervical Cancer Screening

作　　者：范章连 周福花[2] 黄振辉 陈碧文 邱春梅[2] FAN Zhang-lian;ZHOU Fu-hua;HUANG Zhen-hui(Department of Pathology,Sanming Integrated Traditional Chinese and Western Medicine Hospital,Sanming,Fujian,365001,China)

机构地区：[1]三明市中西医结合医院病理科,福建三明365001 [2]三明市中西医结合医院妇产科,福建三明365001

出　　处：《黑龙江医学》2023年第1期16-18,共3页Heilongjiang Medical Journal

摘　　要：目的:分析液基脱落细胞学检查(thinprep cytologic test,TCT)联合人乳头状瘤病毒(human papilloma virus,HPV)、P16蛋白免疫组化染色检测在宫颈癌筛查中的价值。方法:选取2018年8月—2021年1月三明市中西医结合医院进行TCT和HPV检测的424例患者作为研究对象,将TCT和HPV任意一项检测阳性的138例患者进行P16蛋白免疫组化染色、阴道镜下宫颈组织活检。观察TCT、HPV及P16蛋白单项及联合诊断结果,计算各指标单项及联合诊断敏感度、特异度及准确度。结果:138例患者中病理诊断结果慢性炎症、CINⅠ、CINⅡ、CINⅢ、SCC分别为63例、42例、23例、9例、1例;TCT诊断敏感度、特异度、准确度分别为76.00%(57/75)、57.14%(36/63)、67.39%(93/138);HPV诊断阴性、阳性分别为53例、85例;HPV诊断敏感度、特异度、准确度分别为77.33%(58/75)、57.14%(36/63)、68.12%(94/138);P16蛋白诊断阴性、阳性分别为69例、69例,P16蛋白诊断敏感度、特异度、准确度分别为66.67%(50/75)、69.84%(44/63)、68.12%(94/138);TCT联合HPV、P16蛋白诊断敏感度、特异度、准确度分别为90.67%(68/75)、87.30%(55/63)、89.13%(123/138);TCT联合HPV、P16蛋白诊断敏感度、特异度、准确度均高于各单项指标诊断结果,差异有统计学意义(P<0.05)。结论:TCT联合HPV、P16蛋白免疫组化染色检测是筛查宫颈癌较为准确的方法,能够提高宫颈癌检出率,对患者是否需要行阴道镜下活检具有指导意义。Objective: To analyze the value of thinprep cytologic test(TCT) in combination with human papilloma virus(HPV) and P16 protein immunohistochemical staining in cervical cancer screening. Methods: 424 patients who underwent TCT and HPV testing in the hospital from August 2018 to January 2021 were selected as the study subjects. The 138 patients who tested positive for either TCT or HPV were subjected to immunohistochemical staining for P16 protein and colposcopic cervical tissue biopsy. The results of single and combined diagnosis of TCT, HPV and P16 protein were observed, and the sensitivity, specificity and accuracy of single and combined diagnosis of each index were calculated. Results: Among 138 patients, the pathological diagnoses of chronic inflammation, CIN Ⅰ, CIN Ⅱ, CIN Ⅲ, and SCC were 63, 42, 23, 9, and 1, respectively. The diagnostic sensitivity,specificity, and accuracy of TCT were 76.00%(57/75), 57.14%(36/63), and 67.39%(93/138), respectively. The number of negative and positive HPV diagnosis was 53 and 85 cases, respectively, and the sensitivity, specificity and accuracy of HPV diagnosis were77.33%(58/75), 57.14%(36/63) and 68.12%(94/138), respectively. The number of negative and positive P16 protein diagnosis was 69 and 69 cases, respectively, and the sensitivity, specificity and accuracy of P16 protein diagnosis were 66.67%(50/75),69.84%(44/63) and 68.12%(94/138), respectively. The sensitivity, specificity and accuracy of TCT combined with HPV and P16protein diagnosis were 90.67%(68/75), 87.30%(55/63) and 89.13%(123/138), respectively. The diagnostic sensitivity, specificity and accuracy of TCT combined with HPV and P16 protein were higher than the diagnostic results of each single index, and the difference was statistically significant(P<0.05). Conclusion: TCT combined with HPV and P16 protein immunohistochemical staining is a more accurate method to screen for cervical cancer, which can improve the detection rate of cervical cancer and provide guidance on whether patients need to undergo colp

关 键 词：宫颈癌 液基脱落细胞学检查 人乳头状瘤病毒 P16蛋白 免疫组化 

分 类 号：R711.74[医药卫生—妇产科学]