ProExC免疫细胞化学染色与高危人乳头瘤病毒检测在宫颈液基细胞学非典型腺细胞女性中的诊断价值  

Diagnostic value of ProExC immunocytochemical staining and high-risk human papilloma virus testing in women with atypical glandular cells in cervical liquid-based cytology

作　　者：李琦 郭琦 丁莉 LI Qi;GUO Qi;DING Li(Department of Pathology,Jiangxi Maternal and Child Health Hospital,Nanchang,Jiangxi,330006,China)

机构地区：[1]江西省妇幼保健院病理科,江西南昌330006

出　　处：《当代医学》2024年第12期5-9,共5页Contemporary Medicine

基　　金：江西省卫生计生委科技计划(202130794)。

摘　　要：目的探讨ProExC免疫细胞化学染色及高危人乳头瘤病毒(HPV)检测在宫颈液基细胞学非典型腺细胞(AGC)女性中的诊断价值。方法选取2019年2月至2020年12月于江西省妇幼保健院行宫颈液基细胞学诊断AGC病例168例,取剩余液基细胞学标本制成细胞蜡块,进一步行ProExC免疫细胞化学染色。所有病例均行二代杂交捕获技术(HC2)高危HPV检测,以组织病理学诊断为金标准,比较ProExC、HPV及联合检测的诊断效能。结果168例AGC患者中,严重宫颈病变79例,包括鳞状上皮病变32例及腺上皮病变47例。ProExC、HPV及联合检测严重宫颈病变阳性率分别为78.5%、74.7%、81.0%,宫颈原位腺癌(AIS)以上阳性率分别为78.7%、70.2%、78.7%。对严重宫颈病变的诊断,ProExC、HPV及联合检测与组织病理学诊断相比一致性均较好(Kappa值分别为0.699、0.569、0.583,P<0.05);ProExC诊断严重宫颈病变的诊断价值>联合检测>HPV(AUC分别为0.847、0.793、0.784,P<0.05)。对AIS以上病变的诊断,ProExC与组织病理学诊断相比一致性很好(Kappa值为0.883,P<0.05),HPV及两者联合与组织病理学相比一致性较好(Kappa值分别为0.545、0.558,P<0.05);ProExC诊断AIS以上的诊断价值>联合检测>HPV(AUC分别为0.931、0.787、0.772,P<0.05)。结论ProExC、HPV及联合检测均可应用于宫颈液基细胞学非典型腺细胞女性的诊断,其中以ProExC诊断准确性最高。Objective To explore the diagnostic value of ProExC immunocytochemical staining and high-risk human papillomavirus(HPV)test-ing in women with atypical glandular cells(AGC)in cervical liquid-based cytology.Methods 168 cases of AGC diagnosed by cervical liquid-based cytology in Jiangxi Maternal and Child Health Hospital from February 2019 to December 2020 were selected,the remaining liquid-based cytology specimens were made into cell wax blocks,and ProExC immunocytochemistry staining was further performed.All cases were tested for high-risk HPV by hybrid capture 2(HC2),the diagnostic efficacy of ProExC,HPV and combined detection was compared with histopathological diagnosis as the gold standard.Results Among 168 AGC patients,79 cases had severe cervical lesions,including 32 cases of squamous epithelial lesions and 47 cases of glandular epithelial lesions.The positive rates of ProExC,HPV and combined detection of severe cervical lesions were 78.5%,74.7%and 81.0%,respectively,the positive rates of lesions above adenocarcinoma in situ(AIS)were 78.7%,70.2%and 78.7%,respectively.In the diagnosis of severe cervical lesions,the consistency of ProExC,HPV and combined detection was better than that of histopathological diagnosis(Kappa values were 0.699,0.569 and 0.583,respectively,P<0.05);the diagnostic value of ProExC in the diagnosis of severe cervical lesions>combined detec-tion>HPV(AUC were 0.847,0.793,0.784,respectively,P<0.05).For the diagnosis of lesions above AIS,ProExC had good consistency with his-topathological diagnosis(Kappa value was 0.883,P<0.05),and HPV and their combination had good consistency with histopathological diagnosis(Kappa values were 0.545 and 0.558,respectively,P<0.05);the diagnostic value of ProExC lesions above AIS>combined detection>HPV(AUC were 0.931,0.787,0.772,respectively,P<0.05).Conclusion ProExC,HPV,and combined detection can be applied to the diagnosis of atypi-cal glandular cell women in cervical liquid-based cytology,among them,ProExC has the highest diagnostic accuracy.

关 键 词：ProExC 高危人乳头瘤病毒 非典型腺细胞 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]