摘要
【目的】探讨P16/细胞增殖核抗原(Ki67)双染联合人乳头瘤病毒(HPV)基因分型对薄层液基细胞学检查(TCT)阴性患者宫颈癌前病变的鉴别价值。【方法】选取2021年5月至2022年7月在长安医院接受宫颈癌筛查的104例TCT阴性患者,均行P16/Ki67双染检查、HPV基因分型检测及阴道镜病理活检,以阴道镜病理活检结果为金标准,分析P16/Ki67双染检查、HPV基因分型检测与阴道镜病理活检结果的一致性及对TCT阴性患者宫颈癌前病变的诊断价值。【结果】阴道镜病理活检结果显示:104例TCT阴性患者中,共有34例CIN2以上患者,包括14例CIN2患者,18例CIN3患者,2例宫颈鳞癌患者,其余70例均为阴性;P16/Ki67双染用于TCT阴性患者宫颈癌前病变诊断:28例阳性患者与阴道镜病理活检诊断结果一致,64例阴性患者与阴道镜病理活检诊断结果一致,经Kappa一致性检验,Kappa=0.738;HPV基因分型用于TCT阴性患者宫颈癌前病变诊断:25例阳性患者与阴道镜病理活检诊断结果一致,59例阴性患者与阴道镜病理活检诊断结果一致,经Kappa一致性检验,Kappa=0.570;P16/Ki67双染联合HPV基因分型用于TCT阴性患者宫颈癌前病变诊断,有30例阳性患者与阴道镜病理活检诊断结果一致,66例阴性患者与阴道镜病理活检诊断结果一致,经Kappa一致性检验,Kappa=0.825;P16/Ki67双染联合HPV基因分型诊断的灵敏度、特异度、约登指数、准确度分别为90.91%、92.96%、0.839和92.31%,联合诊断的准确性更高。【结论】P16/Ki67双染联合HPV基因分型用于TCT阴性患者宫颈癌前病变诊断准确性较高,可用于临床宫颈癌前病变的早期筛查。
【Objective】To explore the value of P16/proliferating nuclear antigen(Ki67)double staining combined with human papillomavirus(HPV)genotyping in the identification of cervical precancerous lesions in patients with negative liquid-based thin layer cytology test(TCT).【Methods】A total of 104 TCT-negative patients who underwent cervical cancer screening in our hospital from May 2021 to July 2022 were selected,all patients underwent P16/Ki67 double staining,HPV genotyping and colposcopy biopsy.The colposcopy biopsy results as the gold standard,the consistency of P16/Ki67 double staining,HPV genotyping and colposcopy biopsy results was analyzed,and the value of P16/Ki67 double staining combined with HPV genotyping in the diagnosis of cervical precancerous lesions in TCT-negative patients was analyzed.【Results】The results of colposcopy pathological biopsy showed that among the 104 TCT-negative patients,there were 33 patients with cervical intraepithelial neoplasia grade 2 or higher,including 14 patients with CIN2,18 patients with CIN3,and 1 patient with cervical adenocarcinoma,the remaining 71 cases were all negative lesions.P16/Ki67 double staining was used for the diagnosis of cervical precancerous lesions in TCT-negative patients,28 positive patients were consistent with the diagnosis results of colposcopy pathological biopsy,and 64 negative patients were consistent with the diagnosis results of colposcopy pathological biopsy,after Kappa consistency test,Kappa=0.738,the agreement between the two diagnostic methods was general.HPV genotyping was used for the diagnosis of cervical precancerous lesions in TCT-negative patients,25 positive patients were consistent with the diagnosis results of colposcopy biopsy,and 59 negative patients were consistent with the diagnosis results of colposcopy biopsy,after Kappa consistency test,Kappa=0.570.P16/Ki67 double staining combined with HPV genotyping was used for the diagnosis of cervical precancerous lesions in TCT-negative patients,30 positive patients were consistent
作者
韩双
翟华丽
雷芳
杨文艳
HAN Shuang;ZHAI Huali;LEI Fang(Department of Laboratory,Chang'an Hospital,Xi'an Shaanxi 710016)
出处
《医学临床研究》
CAS
2023年第10期1452-1455,共4页
Journal of Clinical Research
基金
陕西省重点研发计划项目(课题编号:2018SF-205)。
