全自动免疫细胞化学染色P16/Ki-67双染在宫颈病变筛查的价值  

The values of fully automated immunocytochemical staining P16/Ki-67 double staining in cervical lesions screening

作　　者：胡红霞 HU Hong-xia(Department of Pathology,Jiagang Hospital,Jiayuguan Gansu 735100,China)

机构地区：[1]酒钢医院病理科,甘肃嘉峪关735100

出　　处：《中华养生保健》2024年第14期166-170,共5页CHINESE HEALTH CARE

基　　金：嘉峪关市科技计划项目任务书(22-B14)。

摘　　要：目的探讨与分析全自动免疫细胞化学染色P16/Ki-67双染在宫颈病变筛查的价值。方法选取2022年4月—2023年6月在酒钢医院进行宫颈病变筛查的120例患者作为研究对象,所有患者都给予液基薄层细胞学(thinprep cytologic test,TCT)检查、病理检查、HPV检测与全自动免疫细胞化学染色P16/Ki-67双染检查,判定筛查结果。结果在120例患者中,P16/Ki-67双染阳性28例,总阳性率为23.3%。液基薄层细胞学检查判断为良性反应性细胞改变67例、宫颈未明确诊断意义的非典型鳞状上皮细胞37例、低级别宫颈鳞状上皮内病变12例、高级别宫颈鳞状上皮内病变4例,其P16/Ki-67双染阳性率分别为16.4%、21.6%、41.6%、100.0%。在120例患者中,病理检查判断:正常16例,宫颈上皮内瘤变Ⅰ级85例、宫颈上皮内瘤变Ⅱ级14例、宫颈上皮内瘤变Ⅲ级4例、宫颈癌1例,其P16/Ki-67双染阳性率分别为6.2%(1例)、15.3%(13例)、71.4%(10例)、75.0%(3例)、100.0%(1例),差异有统计学意义(P<0.05)。以病理检查结果作为金标准,全自动免疫细胞化学染色P16/Ki-67双染在宫颈病变中的敏感性与特异性分别为73.7%(14/19)、86.1%(87/101)。ROC曲线分析显示全自动免疫细胞化学染色P16/Ki-67双染在宫颈病变筛查的曲线下面积为0.872,Kappa值为0.824。结论全自动免疫细胞化学染色P16/Ki-67双染在宫颈病变筛查诊断宫颈癌的敏感性与特异性都比较高,具有很好的临床应用价值。Objective To explore and analysis the values of fully automated immunocytochemical staining P16/Ki-67 double staining in cervical lesions screening.Methods From April 2022 to June 2023,120 cases of patients who underwent cervical lesion screening at Jiagang Hospital were selected as the research subjects.All patients were underwent thinprep cytology test(TCT),pathological examination,and automatic immunocytochemical staining P16/Ki-67 double staining,and were to determine the screening results.Results There were 28 cases were positive for P16/Ki-67 double staining in the 120 cases,with a total positive rate of 23.3%.67 cases of benign reactive cell changes,37 cases of atypical squamous epithelial cells with unclear diagnostic signifi cance in the cervix,12 cases of low-level cervical squamous intraepithelial lesions,4 cases of high-level cervical squamous intraepithelial lesions.The positive rates of P16/Ki-67 double staining were 16.4%、21.6%、41.6%、100.0%,respectively,with compared were significant differences(P<0.05).Pathological examination determined that 16 cases were normal,85 cases of cervical intraepithelial neoplasia grade I,14 cases of cervical intraepithelial neoplasia gradeⅡ,4 cases of cervical intraepithelial neoplasia gradeⅢ,and 1 cases of cervical cancer.The positive rates of P16/Ki-67 double staining were 6.2%、15.3%、71.4%、75.0%and 100.0%,respectively,with compared were signifi cant diff erences(P<0.05).Using pathological examination results as the gold standard,the sensitivity and specifi city of P16/Ki-67 double staining in cervical lesions screening were 73.7%(14/19)and 86.1%(87/101),respectively.Receiver operating characteristic curve analysis showed that the area under the curve of automatic immunocytochemical staining P16/Ki-67 double staining in cervical lesion screening were 0.872,and the Kappa value was 0.824.Conclusion The sensitivity and specifi city of P16/Ki-67 double staining in cervical lesions screening and diagnosis are relatively high,and it has good clinical value.

关 键 词：全自动免疫细胞化学染色 P16/Ki-67双染 宫颈病变 液基薄层细胞学检查 病理检查 

分 类 号：R737.33[医药卫生—肿瘤]