薄层液基细胞学、高危型人乳头瘤病毒及p16/Ki-67双重染色用于子宫颈病变诊断的临床效能分析  

Clinical efficacy analysis of thinprep cytologic test,high-risk human papillomavirus and p16/Ki-67 dualstaining in the diagnosis of cervical lesions

作　　者：沈苗 郎月华 吴芳芳 孔建平[1] SHEN Miao;LANG Yuehua;WU Fangfang;KONG Jianping(The First People's Hospital of Jiande City,Jiande Zhejiang 311600,China)

机构地区：[1]浙江省建德市第一人民医院,建德311600

出　　处：《中国妇产科临床杂志》2024年第1期16-19,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：建德市科技发展计划项目(2021YW06)。

摘　　要：目的 探讨薄层液基细胞学、高危型人乳头瘤病毒及p16/Ki-67双重染色用于子宫颈病变诊断的临床效能。方法 回顾性纳入2018年1月至2022年6月于建德市第一人民医院行子宫颈癌筛查女性共411例,均接受薄层液基细胞学、高危型人乳头瘤病毒及p16/Ki-67双重染色检查,分析三种检查结果间的相关性,并进一步评估三者单独及联合用于高级别鳞状上皮内病变及以上病变诊断的临床效能。结果 各薄层液基细胞学亚组、高危型人乳头瘤病毒亚组及病理组织学诊断学亚组p16/Ki-67双重染色阳性率比较差异有统计学意义(P <0.05);高级别鳞状上皮内病变亚组和宫颈鳞癌亚组p16/Ki-67双重染色阳性率显著高于其他亚组(P <0.05);16/18亚型亚组p16/Ki-67双重染色阳性率显著高于其他12亚型阳性亚组、阴性亚组(P <0.05);高级别鳞状上皮内病变亚组和宫颈鳞癌亚组p16/Ki-67双重染色阳性率显著高于其他亚组(P <0.05)。Spearman相关性分析结果显示,p16/Ki-67双重染色阳性率与薄层液基细胞学及高危型人乳头瘤病毒检测结果均呈正相关(P <0.05)。以病理组织学诊断结果作为金标准,薄层液基细胞学、高危型人乳头瘤病毒及p16/Ki-67双重染色单独及联合用于高级别鳞状上皮内病变及以上病变诊断临床效能比较差异有统计学意义(P <0.05);其中三者联合检测的灵敏度最高,而p16/Ki-67双重染色检测的约登指数最大。结论 子宫颈病变p16/Ki-67双重染色结果与薄层液基细胞学及高危型人乳头瘤病毒诊断结果具有相关性;三者联合诊断高级别鳞状上皮内病变及以上病变敏感度最高,而p16/Ki-67双重染色综合诊断效能最佳。Objective To investigate the clinical efficacy of thinprep cytologic test(TCT),high-risk human papillomavirus(HPV) test and p16/Ki-67 dual-staining in the diagnosis of cervical lesions.Methods Clinical data of 411 women with cervical cancer screening were retrospectively analyzed between January 2018 and June 2022 in the First People's Hospital of Jiande City and were examined by TCT,HPV test,and p16/Ki-67 dual-staining to analyze the correlation between detection results of above three tests,and to further evaluate the clinical efficacy of the three tests alone and in combination for the diagnosis of high-grade squamous intraepithelial lesions(HSIL) and above.Results There were significant differences in the positive rates of p16/Ki-67 dual-staining among TCT subgroups,HPV subgroups and histopathological diagnostic subgroups(P < 0.05).The positive rate of p16/Ki-67 dual-staining in the HSIL and cervical squamous cell carcinoma subgroups was significantly higher than the other subgroups(P <0.05).The positive rate of p16/Ki-67 dual-staining in subtype 16/18 subgroup was significantly higher than the other 12 subtype positive subgroup and negative subgroup(P < 0.05).The positive rate of p16/Ki-67 dual-staining in HSIL and cervical squamous cell carcinoma subgroups was significantly higher than the other subgroups(P < 0.05).Spearman correlation analysis showed that the positive rate of p16/Ki-67 dual-staining was positively correlated with the results of TCT and HPV detection(P < 0.05).There were significant differences in the clinical efficacy of thinprep cytologic test,HPV and p16/Ki-67dual-staining alone and in combination in the diagnosis of HSIL + and above by histopathological diagnosis as gold standard(P < 0.05).The combined sensitivity of the three methods was the highest,and p16/Ki-67 dual-staining possess the highest Yoden index.Conclusion The results of p16/Ki-67 dual-staining of cervical lesions were correlated with the results of cytology and high-risk HPV diagnosis and the combination of above three me

关 键 词：薄层液基细胞学 人乳头瘤病毒 P16 KI-67 子宫颈病变 

分 类 号：R737.33[医药卫生—肿瘤]