p16/微小染色体维持蛋白2免疫细胞化学双染在宫颈癌筛查中的应用价值  

Application value of p16/microchromosome maintenance protein 2 immunocytochemical double staining in cervical cancer screening

作　　者：李菲 王涛 段赞 詹世宁 朱彦玲[2] 臧二梅 LI Fei;WANG Tao;DUAN Zan;ZHAN Shining;ZHU Yanling;ZANG Ermei(Department of Pathology,Xuzhou Hospital Affiliated to Jiangsu University,Xuzhou Cancer Hospital,Jiangsu Province,Xuzhou221000,China;Department of Gynecologic Oncology,Xuzhou Hospital Affiliated to Jiangsu University,Xuzhou Cancer Hospital,Jiangsu Province,Xuzhou221000,China;Physical Examination Center,Xuzhou Hospital Affiliated to Jiangsu University,Xuzhou Cancer Hospital,Jiangsu Province,Xuzhou221000,China)

机构地区：[1]江苏大学附属徐州医院(徐州市肿瘤医院)病理科,江苏徐州221000 [2]江苏大学附属徐州医院(徐州市肿瘤医院)妇瘤科,江苏徐州221000 [3]江苏大学附属徐州医院(徐州市肿瘤医院)体检中心,江苏徐州221000

出　　处：《中国当代医药》2023年第31期15-18,共4页China Modern Medicine

基　　金：江苏大学医教协同创新基金项目(JDYY2023046)。

摘　　要：目的探讨p16/微小染色体维持蛋白2(MCM2)免疫细胞化学双染在宫颈癌筛查中的应用价值。方法选取2022年7月至12月于徐州市肿瘤医院进行人乳头瘤病毒(HPV)分型及薄层液基细胞学检查(TCT)检测的525例宫颈癌筛查患者作为研究对象。所有患者均行HPV分型检测、TCT检测、p16/MCM2双染及阴道镜和活检。分析p16/MCM2表达与高危型人乳头瘤病毒(HR-HPV)感染、宫颈病变的关系,比较p16/MCM2、HR-HPV及TCT诊断宫颈病变的敏感度、特异度及准确率。结果HPV16/18阳性患者、其他HR-HPV阳性患者的p16/MCM2阳性占比高于HPV阴性,差异有统计学意义(P<0.017);HPV16/18阳性患者的p16/MCM2阳性占比与其他HR-HPV阳性比较,差异无统计学意义(P>0.017);宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ、CINⅢ、宫颈鳞癌(SCC)患者中的p16/MCM2阳性占比高于良性病变患者,差异有统计学意义(P<0.005);p16/MCM2、HR-HPV诊断敏感度高于TCT,p16/MCM2、TCT诊断特异度高于HR-HPV,p16/MCM2诊断准确率高于TCT,差异有统计学意义(P<0.017);p16/MCM2与HR-HPV诊断敏感度、p16/MCM2与TCT诊断特异度、p16/MCM2与HR-HPV诊断准确率、HR-HPV与TCT诊断准确率比较,差异无统计学意义(P>0.017)。结论p16/MCM2免疫细胞化学双染诊断宫颈病变敏感度、特异度及准确率均较高,能够识别宫颈异常细胞,降低宫颈病变的漏诊率及误诊率。Objective To investigate the application value of p16/microchromosome maintenance protein 2(MCM2)immunocytochemical double staining in cervical cancer screening.Methods A total of 525 patients with cervical cancer screening who underwent human papillomavirus(HPV)typing and thinprep cytology test(TCT)detection in Xuzhou Cancer Hospital from July to December 2022 were selected as the research objects.All patients underwent HPV typing test,TCT test,p16/MCM2 double staining,colposcopy and biopsy.The relationship between p16/MCM2 expression and high risk human papillomavirus(HR-HPV)infection and cervical lesions were analyzed,and the sensitivity,specificity and accuracy of p16/MCM2,HR-HPV and TCT diagnosis of cervical lesions were compared.Results The proportions of p16/MCM2 positive in HPV16/18 positive patients and other HR-HPV-positive patients were higher than that of HPV-negative patients,the differences were statistically significant(P<0.017).There was no significant difference in p16/MCM2 positive ratio between HPV16/18 positive patients and other HR-HPV positive patients(P>0.017).The positive proportions of p16/MCM2 in patients with cervical intraepithelial neoplasia(CIN)Ⅰ,CINⅡ,CINⅢand squamous cervical carcinoma(SCC)were higher than that in benign lesions,and the differences were statistically significant(P<0.005).The diagnostic sensitivity of p16/MCM2 and HR-HPV was higher than that of TCT,the diagnostic specificity of p16/MCM2 and TCT were higher than that of HR-HPV,and the diagnostic accuracy of p16/MCM2 was higher than that of TCT,the differences were statistically significant(P<0.017).There were no significant differences in diagnostic sensitivity between p16/MCM2 and HR-HPV,diagnostic specificity between p16/MCM2 and TCT,diagnostic accuracy between p16/MCM2 and HR-HPV,diagnostic accuracy between HR-HPV and TCT(P>0.017).Conclusion P16/MCM2 immunocytochemical double staining has high sensitivity,specificity and accuracy in the diagnosis of cervical lesions,which can identify cervical abnormal cells

关 键 词：宫颈癌 P16 微小染色体维持蛋白2 免疫细胞化学双染 诊断效能 

分 类 号：R737.33[医药卫生—肿瘤]