摘要
目的探討細胞塊切片P16和Ki-67免疫組化在宮頸細胞學病變診斷中的意義。方法收集宮頸液基細胞學檢查診斷為不典型鱗狀上皮-性質未明(ASC-US)、不典型鱗狀上皮-未排除高度鱗狀上皮內病變(ASC-H)、低度鱗狀上皮內病變(LSIL)及高度鱗狀上皮內病變(HSIL)的病例100例,將細胞學檢查後剩餘的標本製成細胞塊切片,進行P16和Ki-67的免疫組化檢測,並行宮頸活檢,研究細胞學診斷、P16、Ki-67表達與活檢診斷的關係。結果在100例細胞學診斷中,ASC-US 41例、LSIL 34例、ASC-H 7例、HSIL 18例。活檢診斷宮頸炎47例,CIN130例、CIN2-317例、宮頸癌6例。細胞學診斷ASC-US、LSIL、ASC-H、HSIL與活檢診斷的符合率分別為75.6%、58.8%、57.1%、72.2%,各組符合率之間的差異在統計學上無顯著性意義(P=0.40)。細胞學診斷為ASC-US、ASC-H、LSIL和HSIL的P16陽性率分別為22.0%、85.7%、64.7%和94.4%,Ki-67陽性率分別為17.1%、85.7%、58.8%和94.4%,P16和Ki-67陽性率在各組的差異在統計學上具有顯著性意義(P<0.05)。結論細胞學診斷有較高的假陽性和假陰性,結合檢測P16及Ki-67免疫組化,可明顯提高細胞學診斷與活檢診斷的陽性符合率,提示細胞塊切片P16及Ki-67檢測應成為宮頸細胞學的輔助診斷指標。
Objective To explore the significance of P16 and Ki-67 immunostaining on cell block sections for cervical cytology diagnosis.Methods One hundred cases of cervical intraepithelial neoplasia diagnosed by liquid based cytology,including atypical squamous cells of unkown nature(ASC-US),atypical squamous cells-cannot exclude HSIL(ASC-H),low grade squamous intraepithelial lesions(LSIL)and high grade squamous intraepithelial lesions(HSIL),were collected.Cell blocks were prepared from residual liquid based cytology specimens and were immunohistochemically stained with P16 and Ki-67 antibodies,simultaneously cervical biopsy were performed.Finally,the relationships between cytology,biopsy diagnosis and immunoreactions of P16 and Ki-67 were analyzed.Results In 100 cases of specimens,41 cases of ASC-US,7 cases of ASC-H,34 cases of LSIL and 18cases of HSIL were diagnosed by liquid based cytological test,while 47 cases of cervicitis,30 cases of cervical intraepithelial neoplasia(CIN1),17 cases of CIN2-3 and 6 cases of squamous cell carcinoma(SCC)were diagnosed by cervical biopsy.The positive consistency rates of cytological diagnosis of ASC-US,LSIL,ASC-H,HSIL with biopsy diagnosis were 75.6%,58.8%,57.1%and 72.2%,respectively.There are no statistically significant difference of positive consistency rates between above groups(P=0.40).The positive rate of P16 in ASC-US,ASC-H,LSIL and HSIL were 22.0%,85.7%,64.7%and 94.4%,while Ki-67 were 17.1%,85.7%,58.8%and 94.4%,respectively.There are statistically significant difference of P16 and Ki-67 positive rates between above groups(P<0.05).Conclusion There are high incidence rate of false positive and false negative in cytological diagnosis.The positive consistency rates of cytological diagnosis with biopsy diagnosis can be raised by combining with P16 and Ki-67 immunohistochemical stains on the cell block sections.The results suggest P16 and Ki-67 immunostains on the cell block sections should be used as detective markers in cervical cytological diagnosis.
作者
馬毓娜
肖剛
文劍明
李珉珉
溫旺榮
MA Iok Na;XIAO Gang;WEN Jian Ming;LI Min Min;WEN Wang Rong(Department of Pathology,Kiang Wu Hospital,Macao,China;Clinical Laboratory,Jinan University,Guangzhou,China)
出处
《镜湖医学》
2014年第1期7-12,共6页
MEDICAL JOURNAL OF KIANG WU
关键词
宮頸細胞學
細胞塊切片
免疫組化
P16
KI-67
Liquid based cytological test
Cell block section
Immunohistochemistry
P16
Ki-67
