p16蛋白与HPV-DNA、TCT联合应用在宫颈癌病变筛查的研究  

Research of Screening for Cervical Cancer Lesions in the Application of Combined with p16 Protein HPV-DNA and TCT

作　　者：聂君儿 许慧杰 欧阳东成 屈群峰 黄珊珊[2] 杨细飞 刘腾飞[7] NIE Jun-er;XU Hui-jie;OUYANG Dong-cheng;QU Qun-feng;HUANG Shan-shan;YANG Xi-fei;LIU Teng-fei(School of Public Health,Southern Medical University,Guangzhou,Guangdong,510515,China;Guangdong Lingnan Institute of Technology,Guangzhou,Guangdong,510640,China;Baiyun District Maternal and Child Health Hospital,Guangzhou,Guangdong,510410,China;Guangzhou Huaxia Vocational College,Guangzhou,Guangdong,510935,China;Guangzhou Hybribio Medical Laboratory Limited,Guangzhou,Guangdong,510700,China;Shenzhen Key Laboratory of Modern Toxicology,Shenzhen Medical Key Discipline of Health Toxicology,Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong,518020,China;Guangdong Provincial Key Laboratory of Molecular Tumor Pathology,Department of Pathology,School of Basic Medical Sciences,Southern Medical University,Guangzhou,Guangdong,510515,China)

机构地区：[1]南方医科大学公共卫生学院,广东广州510515 [2]广东岭南职业技术学院,广东广州510640 [3]广州市白云区妇幼保健院,广东广州510410 [4]广州华夏职业学院,广东广州510935 [5]广州凯普医学检验所有限公司,广东广州510700 [6]深圳市疾病预防控制中心深圳市现代毒理学重点实验室深圳市卫生毒理学医学重点学科,广东深圳518020 [7]南方医科大学基础医学院病理学系广东省肿瘤分子病理学重点实验室,广东广州510515

出　　处：《现代生物医学进展》2024年第20期3839-3844,共6页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(82171583);深圳市基础研究重点项目(JCYJ20200109150717745)。

摘　　要：目的:探讨p16蛋白与HPV-DNA、TCT联合应用在宫颈癌病变筛查的价值研究。方法:回顾性分析2023年02月至2023年12月在广州市某地区妇幼保健院就诊疑似患者3952例,并行p16蛋白检测与HPV-DNA筛查、液基薄层细胞(TCT)以及宫颈癌病理切片(HE)鉴定,分析、比较不同年龄段组女性p16蛋白免疫组化、HPV-DNA分型以及TCT检测结果相关性。结果:p16蛋白检测阳性率随着HPV-DNA筛查增高有递增趋势(差异具有统计学意义,P<0.05)。p16蛋白检测随着TCT诊断结果分级NILM与ASC-US、ASC-H、LSIL、HSIL、SCC组别的升高有递增趋势(差异具有统计学意义,P<0.05)。p16蛋白检测随着宫颈癌病理切片HE染色分级增高有递增趋势(差异具有统计学意义,P<0.05)。p16蛋白检测阳性率与患者年龄关系密切;在3952例妇女中HPV-DNA筛查阳性患者1836例,阳性率约46.46%;TCT检测结果阳性有1528名,阳性率约38.66%;按年龄分组结果:发病年龄30岁以后有上升趋势,41-50岁是发病高峰年龄段,60岁以后发病率下降,年龄呈抛物线向上及下趋势;宫颈癌发病还有呈年轻化趋势。结论:p16蛋白与HPV-DNA、TCT联合应用提高了宫颈癌及其癌前病变筛查的准确度。Objective:To investigate the effect p16 protein combined with HPV-DNA and TCT in screening cervical cancer lesions.Methods:A retrospective analysis was conducted on 3952 suspected patients who visited a women's and children's health hospital in a certain area of Guangzhou from February 2023 to December 2023.Parallel p16 protein detection,HPV-DNA screening,Thin-prep cytologic test(TCT),and cervical cancer histopathological section(HE)identification were performed.The correlation between p16 protein immunohistochemistry,HPV-DNA typing,and TCT test results in different age groups of women was analyzed and compared.Results:The positive rate of p16 protein detection tended to increase with the increase in HPV-DNA screening(the difference was statistically significant,P<0.05).p16 protein detection tended to increase with the grading of TCT diagnosis results from NILM to ASC-US,ASC-H,LSIL,HSIL,and SCC groups(the difference was statistically significant,P<0.05).p16 protein detection tended to increase with the grading of cervical cancer histopathological sections by HE staining(the difference was statistically significant,P<0.05).The positive rate of p16 protein detection was closely related to patient age;among the 3952 women,1836 were HPV-DNA screening positive,with a positive rate of approximately 46.46%;1528 were TCT positive,with a positive rate of approximately 38.66%;grouped by age,the onset age tended to increase after 30 years old,peaked at 41-50 years old,and decreased after 60 years old,showed an upward and downward parabolic trend with age;the onset of cervical cancer also showed a trend of younger age.Conclusion:The combination of p16 protein,HPV-DNA,and TCT improved the accuracy of cervical cancer and precancerous lesion screening.

关 键 词：P16蛋白 宫颈癌 HPV-DNA 液基薄层细胞TCT 癌前病变 

分 类 号：R737.33[医药卫生—肿瘤]