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p16^(INK4a)/Ki67免疫细胞化学双染在检出宫颈癌及癌前病变中的作用 被引量:18

Detection of Cervical Cancer or Precancerous Lesion by p16^(INK4a)/Ki67 Dual Stain Cytology
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摘要 目的:探讨p16^(INK4a)/Ki67免疫细胞化学双染在检出宫颈癌及癌前病变中的作用。方法:选择妇科门诊就诊妇女131名,平均年龄(39±10.73)岁,进行宫颈上皮细胞p16^(INK4a)/Ki67免疫细胞化学双染检测、宫颈细胞学检查和高危型HPV检测。p16^(INK4a)/Ki67双染采用CINtec PLUS细胞学试剂盒方法,宫颈细胞学应用Thinprep或Surepath液基薄片的方法,高危型HPV检测采用Cobas 4800检测系统。结果:p16^(INK4a)/Ki67免疫细胞化学双染检出CIN2及以上病变的灵敏度为92.8%,特异度为58.8%,AUC为0.773,高于细胞学检查(82.5%,44.1%,0.633);其特异度及AUC也明显高于高危型HPV检测(17.6%,0.562),差异有统计学意义(P<0.05)。p16^(INK4a)/Ki67免疫细胞化学双染联合细胞学检查漏诊率最低。结论:p16^(INK4a)/Ki67双染检测具有更高的灵敏性及特异性,降低了宫颈高级别鳞状上皮病变的漏诊率及过度诊断,有助于提高宫颈癌的检出率。 Objective: To investigate the effect of p161NK4a/Ki67 dual stain cytology on the detection of cervical cancer or precancerous lesion. Methods: The cervical cytology, hr HPV test, pl61NK4a/Ki67 dual stain cytology and biopsy were performed for a total of 131 women with an average age of 39 :t: 10, 73 in outpatient of gynecologic department from July 2016 to Jan. 2017. CINtec Plus kit was used for p161Nxga/Ki67 dual stain cytology. Thinprep or Surepath liquid based cytol- ogy was applied for cytology test. Cobas 4800 system was chosen for hrHPV test. Results : The sensitivity and specificity of p161NK4a/Ki67 dual stain cytology (92.8%, 58. 8% ) were significantly higher than those of the liquid based cytology (82.5%, 44.1% ) , and its specificity was much higher than that of rhHPV test (17.6%, P〈0.05) when CIN2 was set as the cutoff, p16INK4a/Ki67 dual stain cytology has the highest AUC ( 0. 773 ) among these three methods ( P 〈 0.05 ). Combination of p16INK4a/Ki67 dual stain cytology and cervical liquid based cytology got the lowest omission diagnostic rate for CIN2 and greater lesions. Conclusion: p161NK4a/Ki67 dual stain cytology has relatively higher sensitivity and specifici- ty, thus can help decrease the omission diagnostic rate and over-diagnosis rate of high grade cervical squamous epithelial le- sions, as well as improve the detection rate of cervical cancer.
出处 《肿瘤预防与治疗》 2017年第6期427-432,共6页 Journal of Cancer Control And Treatment
基金 国家自然科学基金(编号:81472429)
关键词 p16INK4a/Ki67双染 宫颈细胞学 高危型HPV检测 CIN 宫颈癌 p161NK4a/Ki67 dual stain Cervical cytology hrHPV test CIN Cervical cancer
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