摘要
目的探讨HPV DNA分型联合p16免疫细胞化学在宫颈癌前病变及宫颈癌的诊断价值。方法收集2019年12月至2021年8月宫颈癌筛查存在宫颈病变的妇女606例,根据病理检查结果分为CINⅠ组(n=201)、CINⅡ组(n=185)、CINⅢ组(n=152)、宫颈癌组(n=68),所有患者均进行HPVDNA分型、p16免疫组化检查和癌组织病理学活检(金标准),比较各组患者HPVDNA分型、p16免疫组化检查结果,采用四格表法分析HPVDNA分型、p16蛋白诊断宫颈癌的敏感度、特异度、阳性预测值、阴性预测值、准确率。结果本实验606例研究对象中,HPVDNA低危型阳性患者244例,占比40.26%,HPV DNA高危型阳性患者250例,占比41.25%,CINⅠ、CINⅡ、CINⅢ、宫颈癌患者HPV DNA高危型阳性占比分别为13.43%、32.97%、62.50%、98.53%,不同宫颈病变疾病HPV DNA结果差异有统计学意义(χ^(2)=193.328,P<0.001)。本实验606例研究对象中,p16蛋白阳性患者309例,占比50.99%,CINⅠ、CINⅡ、CINⅢ、宫颈癌患者p16蛋白阳性占比分别为36.32%、42.16%、60.53%、97.06%,不同宫颈病变疾病p16蛋白阳性结果差异有统计学意义(χ^(2)=86.364,P<0.001)。四格表法分析显示,HPV DNA高危型阳性诊断宫颈癌的敏感度为98.53%,特异度为65.99%,阳性预测值为26.80%,阴性预测值为99.72%,准确率为69.64%。p16蛋白阳性诊断宫颈癌的敏感度为97.06%,特异度为54.83%,阳性预测值为21.36%,阴性预测值为99.33%,准确率为59.57%。四格表法分析显示,HPVDNA联合p16蛋白诊断宫颈癌的敏感度为100.00%,特异度为73.98%,阳性预测值为32.69%,阴性预测值为100.00%,准确率为76.90%。结论HPV DNA联合p16免疫组化检查可提高宫颈癌前病变和宫颈癌病变中检查率,具有重要临床推广价值。
Objective To investigate the diagnostic value of HPV DNA typing combined with p16 immunocytochemistry in cervical precancerous lesions and cervical cancer.Methods From December 2019 to August 2021,606 women with cervical lesions were collected and divided into CINⅠ group(n=201),CINⅡ group(n=185),CINⅢ group(n=152)and cervical cancer group(n=68)according to pathological examination results.All patients underwent HPV DNA typing,p16immunohistochemical examination and cancer histopathological biopsy(gold standard).The results of HPV DNA typing and p16 immunohistochemical examination were compared between the groups.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of HPV DNA typing and p16 protein in the diagnosis of cervical cancer were analyzed by four-grid table method.Results Of the 606 subjects in this study,244 cases were HPV DNA low-risk positive patients,accounting for 40.26%,and 250 cases were HPV DNA high-risk positive patients,accounting for 41.25%.The proportion of high-risk HPV DNA positive in patients with CINⅠ,CINⅡ,CINⅢ and cervical cancer was 13.43%,32.97%,62.50% and 98.53%,respectively.There were significant differences in HPV DNA results among different cervical lesions(χ^(2)=193.328,P<0.001).Among the 606 subjects in this study,309 patients were p16 protein positive,accounting for 50.99%.The p16 protein positive rates of CINⅠ,CINⅡ,CINⅢ and cervical cancer patients were 36.32%,42.16%,60.53% and 97.06%,respectively.There were significant differences in the positive results of p16 protein among different cervical lesions(χ^(2)=86.364,P<0.001).The four-grid table analysis showed that the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of HPV DNA high-risk positive diagnosis of cervical cancer were 98.53%,65.99%,26.80%,99.72% and 69.64%,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of positive p16 protein in the diagnosis of cervical cancer we
作者
李美波
LI Meibo(Huizhou Sixth People’s Hospital,Huizhou,Guangdong 516211,China)
出处
《中国优生与遗传杂志》
2023年第3期575-579,共5页
Chinese Journal of Birth Health & Heredity
基金
2019年度惠州市第六人民医院优秀青年医师学术培育项目(HL2019Y109)。
关键词
宫颈液基细胞学
免疫细胞化学
宫颈癌
诊断价值
cervical liquid-based cytology
immunocytochemistry
cervical cancer
diagnostic value
