摘要
目的探讨p16/Ki-67双染对细胞学异常孕妇产后组织学结果的预测价值。方法选取本院宫颈脱落细胞异常的孕早期妇女53例,行p16/Ki-67双染,并随访其产后组织学结果,对p16/Ki-67双染与细胞学、组织学诊断的相关性进行统计学分析。结果由于孕期相关改变,有10例细胞学诊断为不典型鳞状细胞-倾向高度鳞状上皮内病变(ASC-H)或高度鳞状上皮内病变(HSIL),随访其组织学诊断为低度上皮内病变或宫颈炎,过诊断比例高达48%。过诊断10例孕妇其p16/Ki-67双染结果除2例因技术问题不能明确外,其余8例双染结果均为阴性;30例双染阳性者产后随访除1例组织学诊断为低度鳞状上皮内病变(LSIL)外,其余均为HSIL。产后组织学和p16/Ki-67双染结果呈正相关关系(r=0.530,P<0.001),p16/Ki-67双染诊断的灵敏度和特异度分别为69.2%和90.0%。结论p16/Ki-67双染可通过排除细胞学异常孕妇中非HSIL的病例,提高孕期细胞学检查的特异性,从而有效提高产前宫颈细胞学筛查效率。
Objective To investigate the value of p16/Ki-67 dual-staining in predicting the postpartum outcome of pregnant women with abnormal cytology.Methods A total of 53 women in early pregnancy who had abnormal cervical exfoliated cells in our hospital were enrolled,and p16/Ki-67 dual-staining was performed for all women.The women were followed up to obtain postpartum histological results,and a statistical analysis was performed to investigate the correlation of p16/Ki-67 dual-staining with cytological and histological diagnoses.Results Due to related changes during pregnancy,10 women had a cytological diagnosis of atypical squamous cells,cannot exclude high-grade squamous intraepithelial lesion or high-grade squamous intraepithelial lesion(HSIL),and follow-up examination showed a histological diagnosis of low-grade squamous intraepithelial lesion(LSIL)or cervicitis,with an overdiagnosis rate of 48%.Among the 10 pregnant women with overdiagnosis,2 had unclear results of p16/Ki-67 dual-staining due to technical issues and 8 had negative results of p16/Ki-67 dual-staining;among the 30 women with positive results of p16/Ki-67 dual-staining,1 had a histological diagnosis of LSIL and 29 had HSIL.There was a positive correlation between postpartum histology and p16/Ki-67 dual-staining(r=0.530,P<0.001),and p16/Ki-67 dual-staining had a sensitivity of 69.2%and a specificity of 90.0%in diagnosis.Conclusion The p16/Ki-67 dual-staining can improve the specificity of cytological examination during pregnancy and effectively improve the efficiency of prenatal cervical cytological screening by excluding non-HSIL cases from the pregnant women with abnormal prenatal cytology.
作者
周星
陈雪
崔磊
孙吉瑞
李艺萱
张金库
ZHOU Xing;CHEN Xue;CUI Lei;SUN Jirui;LI Yixuan;ZHANG Jinku(Department of Pathology,Baoding First Central Hospital,Baoding 071000,China)
出处
《青岛大学学报（医学版）》
CAS
2021年第2期290-293,共4页
Journal of Qingdao University(Medical Sciences)
基金
河北省医学科学科研重点课题计划(20181490)。
