摘要
目的探讨细胞块p16联合高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)检测在未明确意义的非典型鳞状上皮(atypical squamous cell of undetermined significance,ASCUS)患者分流管理中的作用。方法选取108例子宫颈液基细胞学诊断为ASCUS的病例,同时行HR-HPV杂交捕获法Ⅱ(hybrid capture2,HC2)检测及免疫组化p16染色,均行阴道镜下活检。结果 (1)p16表达率和HR-HPV检出率在炎症组、湿疣/CIN1、CIN2、CIN3组中分别为12.5%(6/48)和31.25%(15/48)、60.53%(23/38)和84.21%(21/38),84.62%(11/13)和92.31%(12/13)、100%(9/9)和100%(9/9),组间差异有统计学意义(P<0.001);湿疣/CIN1组与CIN2/3组间p16表达率分别为60.53%(23/38)、90.91%(20/22),差异有统计学意义(P<0.012 5)。(2)p16联合HR-HPV检测、单纯行p16和HR-HPV检测在ASCUS中分流子宫颈病变的敏感性和阴性预测值分别为98.33%(59/60)、71.67%(43/60)、88.33%(53/60),97.06%(33/34)、71.19%(42/59)、82.5%(33/40),差异均有统计学意义(P<0.05)。p16+/HC2+者高级别病变检出率(44.19%,19/43)与p16-/HC2+者(8%,2/25)比较差异有统计学意义(P<0.001)。结论 p16蛋白可以作为一种辅助诊断CIN的免疫组化标志物。细胞块p16联合HR-HPV检测可以有效分流ASCUS中的子宫颈病变患者。
Purpose To study the effect of high-risk human papillomavirus test combined with detection of p16 expression in cell blocks on triage of patients with atypical squamous cell of undetermined significance （ASCUS）. Methods Selected 108 ASCUS cases were performed with HR-HPV test and p16 immunostaining in cell blocks, followed by colposcopy and cervical biopsy. Results The rates of p16 expression and HR-HPV infection in eervicitis, condyloma/CIN1, CIN2 and CIN3 of cervical biopsy were 12. 5 % （6/48） and 31.25% （ 15/48）, 60. 53% （23/38） and 84. 21% （21/38）, 84. 62% （11/13） and 92. 31% （ 12/13）, and 100% （9/9） and 100% （9/9） , respectively, with significant difference （P 〈 0. 001 ）. The rates of p16 expression in condyloma/CIN1 and CIN2/3 were 60. 53% （23/38）, 90.91% （20/22） respectively, also with significant difference between them （P 〈 0. 012 5 ）. The sensitivity and negative predictive values of p16 combined with HR-HPV, single p16 or HR-HPV were 98.33% （59/60） and 71.67% （43/ 60）, 88.33% （53/60）and97.06% （33/34）, and71.19% （42/59）and82. 5% （33/40）, respectively, （P〈0.05）. The detection rate of high grade lesion in p16 ＋/HR-HPV ＋ and p16 -/HR-HPV ＋ was 44. 19% （19/43） and 8% （2/25）. respectively, （ P 〈 0. 001 ）. Conclusion The immunostaining of p16 protein could contribute to diagnosis of CIN. HR-HPV test combined with p16 immunostaining in cell block could be help in the triage of patients with cervical lesions of ASCUS efficiently.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2014年第8期868-870,875,共4页
Chinese Journal of Clinical and Experimental Pathology
基金
浙江省医药卫生科技成果重点推广计划(2009TG008)
