p16INK4a联合人乳头瘤病毒及液基细胞学检查在宫颈上皮内瘤变临床诊断中的应用  

Application of p16INK4a combined with human papillomavirus and liquid-based cytology in clinical diagnosis of cervical intraepithelial neoplasia

作　　者：肖雪 王宇琦 景尉 钟绍涛 赵翠柳 刘丹 谭荣韶 赖晓岚 XIAO Xue;WANG Yuqi;JING Wei;ZHONG Shaotao;ZHAO Cuiliu;LIU Dan;TAN Rongshao;LAI Xiaolan(Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,China)

机构地区：[1]暨南大学附属广州红十字会医院,广东广州510220 [2]广州市越秀区妇幼保健院,广东广州510060

出　　处：《现代医院》2024年第1期140-143,共4页Modern Hospitals

基　　金：中国营养学会青年人才项目(2020-51);广州市卫生和计划生育科技项目(20211A010017,20181A010015,20221A040001)。

摘　　要：目的分析p16INK4a蛋白、人乳头瘤病毒及液基细胞学检查(LCT)在宫颈癌前病变筛查中的检测效率,为宫颈癌的预防和治疗提供依据。方法分析2019年1月—2020年6月广州市妇女儿童医疗中心的139例住院患者的宫颈上皮细胞p16INK4a染色、人乳头瘤病毒检测及宫颈细胞学检测结果。这些病例包括111例宫颈上皮内瘤变(CIN)患者和28例宫颈炎性疾病患者。比较三种方法单独及联合应用筛查CIN病变的效能。结果在对CIN患者的检测中,p16INK4a、生物微流控芯片和宫颈细胞学检测CIN及以上病变的灵敏度分别为91.89%、94.59%和78.20%,特异度分别为57.14%、17.86%和46.43%,AUC分别为0.75、0.56和0.66。而“p16INK4a+LCT”、“p16INK4a+hrHPV”、“LCT+hrHPV”以及三种方法联合检测的灵敏度分别为96.40%、97.30%、94.59%和99.10%,特异度分别为85.71%、92.86%、89.29%和92.86%,AUC分别为0.91、0.95、0.92和0.96。结论p16INK4a和hrHPV联合检测有助于提高诊断的准确性和早期发现率,从而使得能更早进行干预或治疗。通过这种联合应用,可以更准确地鉴别出低级别和高级别的宫颈上皮内瘤变,为个性化的病患管理提供更多信息。Objective To analyze the detection efficiency of p16INK4a protein combined with human papillomavirus and liquid-based cytology(LCT)in the screening of cervical precancerous lesions,and to provide a basis for cervical cancer prevention and treatment.Methods The results of p16INK4a staining of cervical epithelial cells,human papillomavirus testing and cervical cytology were analyzed in 139 inpatients at Guangzhou Women’s and Children’s Medical Center between January 2019 and December 2020.Of them,there were 111 patients with cervical intraepithelial neoplasia(CIN)and 28 cases of cervical inflammatory disease.The efficacy of the three methods alone and in combination to screen for CIN lesions was compared.Results In the detection of CIN patients,the sensitivity of p16INK4a,microfluidic microarray and cervical cytology for detecting CIN and above lesions was 91.89%,94.59%and 82.88%,with specificity of 57.14%,17.86%and 46.43%,and AUC of 0.75,0.56 and 0.65,respectively;while the sensitivity of“p16INK4a+LCT”,“p16INK4a+hrHPV”,“LCT+hrHPV”and their sensitivity were 96.40%,97.30%,94.59%and 99.10%,their specificity was 85.71%,92.86%,89.29%and 92.86%,and the AUC was 0.91,0.95,0.92 and 0.96,respectively.Conclusion The combined p16INK4a and hrHPV test helps to improve diagnostic accuracy and early detection,thus allowing for earlier intervention or treatment.This combined application allows for more accurate identification of low-grade and high-grade cervical intraepithelial neoplasia,providing more information for individualized patient management.

关 键 词：人乳头瘤病毒 生物微流控芯片 P16INK4A 液基细胞学 宫颈上皮内瘤变 

分 类 号：R711.5[医药卫生—妇产科学]