人乳头瘤病毒分型联合人宫颈液基薄层细胞、P16、Ki67联合检测在宫颈癌前筛查中的应用  

Application of human papilloma virus typing combined with cervical Thinprep liquid-based cytology test,and P16 and Ki67 testing in cervical precancerous screening

作　　者：邓丽霞 周莹 DENG Lixia;ZHOU Ying(Department of Gynecology,Qianjiang Central Hospital of Hubei Province,Hubei,Qianjiang 433100,China)

机构地区：[1]湖北省潜江市中心医院妇科,湖北潜江433100

出　　处：《中国医药科学》2025年第4期57-60,共4页China Medicine And Pharmacy

基　　金：2024年度潜江市公益性行业科研项目(2024GYX012)。

摘　　要：目的探究利用杂交捕获方法检测人乳头瘤病毒(HPV)高危分型、人宫颈液基薄层细胞(TCT)检查、人宫颈细胞切片P16、Ki67联合检测对宫颈癌前筛查的临床价值。方法选取2023年1月至2024年2月在湖北省潜江市中心医院进行宫颈癌筛查的患者1500例,通过整理患者的HPV高危分型、病理活检、TCT、P16、Ki67结果,将病理活检结果作为金标准,分析各筛查方法以及联合筛查方法的检出率以及灵敏度,其中HPV高危分型采用HPV核酸检测试剂盒-杂交捕获化学发光法(DH3)。结果HPV分型与TCT检测均能与病理学检测阳性结果有较好的一致性,其中HPV检测的真阳性率(TPR)为0.94,假阳性率(FPR)为0.26,TCT检测TPR为0.61,FPR为0.22。但联合上述两种方法可有效提高检测率,两者联合TPR为0.89,FPR为0.22。P16、Ki67联合检测在与病理学检测阳性结果上呈高度一致,TPR为0.93,FPR为0.04;与HPV分型检测联合应用能进一步提高检出率,TPR为0.97,FPR为0.04。且该联合检测检出率优于HPV联合TCT检测。结论宫颈癌前筛查应用DH3方法检测HPV高危型联合P16、Ki67双重染色结果可有效提高检出率。Objective To investigate the clinical value of the combination of high-risk human papilloma virus(HPV)typing using the hybrid capture method,human cervical cell Thinprep liquid-based cytology test(TCT),and P16 and Ki67 testing of human cervical cell section for cervical precancerous screening.Methods A total of 1500 samples from patients who underwent cervical screening in Qianjiang Central Hospital of Hubei Province from January 2023 to February 2024 were selected.The detection rate and sensitivity of each screening method and the combined screening method were analyzed by collating the results of patients’high-risk HPV typing,pathological biopsy,TCT,P16 and Ki67 testing,taking the results of pathological biopsy as the gold standard.The high-risk HPV typing was performed using the HPV nucleic acid detection kit-hybrid capture chemiluminescence method(DH3).Results HPV typing and TCT testing both showed good consistency with positive pathological test results,with a true positive rate(TPR)of 0.94 and a false positive rate(FPR)of 0.26 for HPV testing,and a TPR of 0.61 and an FPR of 0.22 for TCT.However,combining the above two methods effectively improved the detection rate,with a TPR of 0.89 and an FPR of 0.22.Combined P16 and Ki67 testing was highly consistent with the positive pathological test results,with a TPR of 0.93 and an FPR of 0.04.And its combination with HPV typing could further improve the detection rate,with a TPR of 0.97 and an FPR of 0.04.Additionally,the detection rate of this combination was better than that of HPV testing combined with TCT.Conclusion The detection of high-risk HPV types by DH3 method combined with the results of P16 and Ki67 double staining can effectively improve the detection rate in cervical precancerous screening.

关 键 词：人乳头瘤病毒高危分型 液基薄层细胞检测 杂交捕获分型P16/Ki67 

分 类 号：R737.33[医药卫生—肿瘤]