摘要
目的探讨细胞免疫化学p16/Ki-67双染预测子宫颈上皮内高级别瘤变及其意义。方法随机收集行细胞学检查标本123例,其中不明意义的非典型鳞状上皮细胞(atypical squamous cell of undetermined significance,ASC-US)及以上病例(合计103例)同时行高危人乳头瘤病毒(high risk-human papillomavirus,HR-HPV)检测且具有活检结果,20例液基细胞学检查未见恶性细胞和上皮内病变细胞(negative for intraepithelial lesion or malignancy,NILM),通过细胞免疫化学双染检测p16/Ki-67结果。结果 20例液基细胞学NLIM的标本中p16/Ki-67双染结果均阴性,ASC-US病例中预测CIN2+的敏感性66.67%、特异性95.92%、阳性预测值50.00%、阴性预测值97.92%,低级别鳞状上皮内病变(low-grade squamous intraepithelial lesions,LSIL)病例中预测CIN2+的敏感性91.67%、特异性95.00%、阳性预测值91.67%、阴性预测值95.00%,高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)病例中预测CIN2+的敏感性92.86%、特异性0、阳性预测值92.86%、阴性预测值0;ASC-US及以上病例预测CIN2+的敏感性89.66%、特异性94.28%、阳性预测值86.67%、阴性预测值95.65%。结论 HR-HPV阳性的ASC-US和LSIL病例中进行p16/Ki-67双染检测,可以明显提高CIN2+检出的预测值,细胞免疫化学p16/Ki-67双染有望成为HPV筛查的有效辅助方法。
Purpose To study of predictive value for detection of high-grade cervical intraepithelial neoplasia （ CIN2 ＋ ） by p16/Ki-67 dual-stained liquid-based cytology. Methods Random collection of 123 women including 103 samples of atypical squamous cell of undetermined significance （ASC-US） and above with results of high-risk human papillomavirus （HR-HPV） testing and cervical biopsy, 20 samples of negative for intraepithclial lesion or malignancy （NILM） by using immunocytoehemical p16/Ki-67 dual-stained and the morphology assessment. Results In normal control group, the expression of p16/Ki-67 dual-stained in squamous epithelial cells were negative. Sensitivity of p16/Ki-67 dual-staind cytology for biopsy-confimled CIN2 ＋ was 66.67% （ASC-US）, 91.67% （LSIL） and 92.86% （HSIL） , specificity rates were 95.92% （ASC-US） , 95.00% （LSIL） and 0 （ HSIL）, positive predictive value were 50. 00% （ASC-US）, 91.67% （LSIL） and 92. 86% （HSIL）, negative predictive value were 97.92% （ ASC-US）, 95.00% （LSIL） and 0 （HSIL）, respectively. Conclusion p16/Ki-67 dual-stained cytology are improved obviously the predictive value for detection of CIN2 ＋ , p16/Ki-67 dual-stained cytology may efficiently complement HPV-based screening programs to prevent cervical cancer.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2017年第3期282-286,共5页
Chinese Journal of Clinical and Experimental Pathology
基金
无锡市卫计委妇幼健康成果技术推广(FYTG2016-2)
无锡市卫生计生科技成果和适宜技术推广(T201645)
