摘要
目的探讨子宫颈脱落细胞块(cell block,CB)中p16/Ki-67免疫细胞化学双染在LSIL的染色判读标准,比较CB联合p16/Ki-67双染对比HR-HPV检测在ASC-US和LSIL患者中的筛查意义。方法收集TCT诊断为ASC-US和LSIL同时行HR-HPV检测的患者标本共210例制备CB,以子宫颈活检诊断为最终标准,评价CB联合p16/Ki-67的筛查效能。结果(1)210例TCT样本制备的CB诊断结果为:NILM 16例、LSIL 171例及HSIL 23例;HPV阳性191例,HPV阴性19例;p16/Ki-67 NILM 57例、LSIL 140例及HSIL 13例。(2)在LSIL和ASC-US样本中,CB的敏感度为90.8%和93.5%,p16/Ki-67双染的特异度为100%和87.5%。(3)按照30岁进行年龄分组,CB和p16/Ki-67双染具有较好的敏感度(95%~100%)和特异度(80%~100%)。结论(1)本研究所采用的p16/Ki-67双染在LSIL的染色判读方法简易、可重复性强,结合细胞形态学能够有效进一步分流ASC-US病例。(2)CB具有较高的敏感度,CB联合p16/Ki-67双染具有较高敏感度和特异度,同时结合HR-HPV三者联合效果等同于活检。
Objective To explore the staining interpretation standard of p16/Ki-67 immunocytochemical staining of cervical exfoliated cell block(CB)in low-grade squamous intraepithelial lesions(LSIL)and to compare the significance of CB combined with p16/Ki-67 dual-staining and HR-HPV in ASC-US and LSIL patients.Methods A total of 210 patients with ASC-US and LSIL diagnosed by TCT and HR-HPV detection were collected.The diagnosis of cervical biopsy was taken as the final standard,and the significance of CB combined with p16/Ki-67 dualstaining in ASC-US and LSIL patients was evaluated.Results(1)The CB diagnostic results of 210 TCT samples included NILM(16 cases),LSIL(171 cases)and HSIL(23 cases);HR-HPV positive(191 cases),HPV negative(19 cases);p16/Ki-67 NILM(57 cases),LSIL(140 cases)and HSIL(13 cases).(2)In cases diagnosed with LSIL and ASC-US,the sensitivity of CB was 90.8%and 93.5%,and the specificity of p16/Ki-67 was 100%and 87.5%,respectively.(3)Taking age 30 as stratification,CB and p16/Ki-67 dual-staining had better sensitivity(95%~100%)and specificity(80%~100%).Conclusions(1)The interpretation criteria of p16/Ki-67 dualstaining in LSIL is simple and reproducible,and it can effectively further shunt ASC-US cases when combined with cell morphology.(2)CB has higher sensitivity and it has higher sensitivity and specificity when combined with p16/Ki-67 dual-staining and the combined effect of CB,p16/Ki-67 and HR-HPV is equivalent to that of biopsy.
作者
张波
杨志敏
康子婧
康凯夫
许萍榕
邹倩
朱伟
王效军
ZHANG Bo;YANG Zhimin;KANG Zijing;KANG Kaifu;XU Pingrong;ZOU Qian;ZHU Wei;WANG Xiaojun(Department of Pathology,the Third Affiliated Hospital of Guangdong Medi-cal University(Longjiang Hospital,Shunde District,Foshan),Foshan 528000,China)
出处
《实用医学杂志》
CAS
北大核心
2022年第22期2795-2800,共6页
The Journal of Practical Medicine
基金
国家自然科学基金(编号:81472275)
佛山市科学技术局医学类科技攻关项目(编号:2020001005507)
广东省自然科学基金(编号:2020A1515010303,2022A1515012171)。
