宫颈病变筛查中p16/mcm2、HPV检测的临床价值  

Clinical values of pl6/mcm2 and human papillomavirus detections of patients for screening their cervical lesion

作　　者：董娇娇 朱彦玲[2] 陆晓媛 孙洁芸 谷佳斐 DONG Jiaojiao;ZHU Yanling;LU Xiaoyuan;SUN Jieyun;GU Jiafei(Xuzhou Medical University,Xuzhou,Jiangsu Province,221004;Xuzhou Cancer Hospital,Xuzhou;The Affiliated Hospital of Xuzhou Medical University,Xuzhou)

机构地区：[1]徐州医科大学,221004 [2]江苏省徐州市肿瘤医院 [3]徐州医科大学附属医院

出　　处：《中国计划生育学杂志》2024年第10期2411-2414,2464,共5页Chinese Journal of Family Planning

基　　金：徐州市重点研发计划(社会发展)项目(KC19147)。

摘　　要：目的:检测宫颈病变中宫颈脱落细胞p16/微小染色体维持蛋白(mcm2)的表达,探讨p16/mcm2与人乳头瘤病毒(HPV)检测在宫颈病变筛查的临床价值。方法:选取2023年5-10月在徐州市肿瘤医院妇科门诊或病房行宫颈癌筛查并符合入组标准的1045例女性,均行p16/mcm2免疫细胞化学双染检测及HPV检测,对p16/mcm2双染确诊为不明意义的非典型鳞状上皮细胞(ASC-US)及以上病变或HPV16/18阳性者行阴道镜检查、活检宫颈组织送病理检查。结果:p16/mcm2阳性率在HPV阴性组、低危HPV组、其他12种HPV阳性组和HPV16/18阳性组依次递增(P=0.000);p16/mcm2阳性表达在其他12种HPV阳性组和HPV16/18阳性组均高于HPV阴性组[OR=4.28(95%CI 2.02~9.04)、OR=76.64(95%CI 36.05~162.93)],在HPV16/18阳性组均高于其他12种HPV阳性组,且随宫颈病变程度加重p16/mcm2阳性表达增高(均P<0.05)。p16/mcm2检测筛查子宫颈上皮内瘤病变CIN1级、CIN2级和CIN3级的灵敏度和阳性预测值(85.0%、89.1%、94.3%,94.1%、97.0%、97.0%)均高于HPV。结论:p16/mcm2双染和HPV存在相关性,两者均可用于宫颈病变筛查;与HPV检测相比,p16/mcm2双染有较高灵敏度和阳性预测,p16/mcm2双染联合HPV检测有望成为有较好应用前景的宫颈癌筛查方案。Objective:To detect the expression of pl6/mcm2 in cervical exfoliated cells of patients with cervical lesions,and to explore the clinical values of pl6/mcm2 and human papillomavirus(HPV)detections of patients for screening their cervical lesion.Methods:1045 women who were screened for cervical cancer in the gynaecology outpatient clinic or ward of Xuzhou cancer hospital and met the included standard from May 2023 to October 2023 were selected as the study subjects.These women were given the pl6/mcm2 immunocytochemistry double-staining and HPV detections.The women with the lesions of atypical squamous epithelial cells of unknown significance(ASC-US)or above by pl6/mcm2 double-staining diagnosis or with the HPV16/18 positivity were given colposcopy,biopsy and pathological examinations.Results:The positive rate of pl6/mcm2 increased in order of the women with HPV negative,of the women with low-risk HPV infection,of the women with the other 12 types of HPV positive and of the women with HPV16/18 positive(P=0.000).The positive expression of p16/mcm2 of the women with the positive other 12 types of HPV was significantly higher than that of the women with the negative HPV(OR=4.28,95%CI 2.02-9.04).The positive expression of p16/mcm2 of women with positive HPV 16/18 was significantly higher than that of the women with the negative HPV(OR=76.64,95%CI 36.05-162.93).The positive expression of p16/mcm2 of the women with positive HPV16/18 was significantly higher than that of the women with the positive other 12 types of HPV.The positive expression of the women increased with the severity of their cervical lesions(all P<0.05).The sensitivity of pl6/mcm2 detection of the women for predicting their cervical lesions of CINI,CINII and CIN II were 85.0%,89.1%and 94.3%,respectively,and the positive predictive value of pl6/mcm2 of the women for predicting their cervical lesions of CIN I,CINI and CIN II were 94.1%,97.0%and 97.0%,respectively,and both of which of the women were significantly higher than those of HPV detection.Conclusio

关 键 词：宫颈癌筛查 免疫细胞化学双染检测 P16 微小染色体维持蛋白 人乳头瘤病毒 宫颈上皮内瘤变 

分 类 号：R737.33[医药卫生—肿瘤]