摘要
目的:探讨p16/Ki-67细胞学双染(下文简称p16/Ki-67双染)和HR-HPV检测在宫颈癌筛查中的应用价值,尤其是在子宫颈高级别鳞状上皮内病变(HSIL)及以上病变中的诊断效能的比较。为HSIL及以上病变提供更加客观的诊断依据。方法:收集2020年5月至2021年5月在南海区人民医院宫颈液基细胞学筛查(TCT)及阴道镜活检的病例,留取141例不同宫颈病变的液基标本作为研究对象。行p16/Ki-67双染、HR-HPV检测、并以阴道镜活检作为细胞筛查的金标准,比较p16/Ki-67双染、HPV E6/E7 mRNA检测在不同宫颈病变中的敏感性、特异性、阳性预测值与阴性预测值,探讨其在宫颈癌筛查中的应用价值。 结果: (1)HSIL及以上组织病变中p16/Ki-67阳性率(91.4%)明显高于炎症(1.5%)及子宫颈低级别鳞状上皮内病变(LSIL)(2.7%);(2)p16/Ki-67双染在诊断HSIL中的灵敏度、特异度、阳性预测值、阴性预测值分别为 91.4% 、97.2%、94.1%、98.1%,相比于TCT及HR-HPV检测而言,在诊断HSIL及以上病变时,可在保证灵敏度的同时,提高特异性、阳性预测值、阴性预测值。 结论: p16/Ki-67双染为宫颈HSIL及以上病变的诊断提供更加客观的诊断依据,提高HSIL及以上宫颈病变的准确率,减少不必要的漏诊及误诊。
Objective:To explore the application value of p16/Ki-67 cytological double staining(hereinafter referred to as p16/Ki-67 double staining)and HR-HPV detection in cervical cancer screening,especially the comparison of diagnostic efficacy in cervical high-grade squamous intraepithelial lesions(HSIL)and above.To provide more objective diagnostic basis for HSIL and above lesions.Methods:The cases of cervical cytology screening(TCT)and colposcopy biopsy in Nanhai District People’s Hospital from May 2020 to May 2021 were collected,and 141 samples of different cervical lesions were collected as research objects.p16/Ki-67 double staining and HR-HPV detection were performed,and colposcopy biopsy was used as the gold standard for cell screening.The sensitivity,specificity,positive predictive value and negative predictive value of p16/Ki-67 double staining and HPV E6/E7 mRNA detection in different cervical lesions were compared,and the application value of the detection in cervical cancer screening was discussed.Results:(1)The positive rate of p16/Ki-67 in HSIL and above tissues(91.4%)was significantly higher than that in inflammation(1.5%)and low-grade squamous intraepithelial lesions(LSIL)(2.7%).(2)The sensitivity,specificity,positive predictive value and negative predictive value of p16/Ki-67 double staining in the diagnosis of HSIL were 91.4%,97.2%,94.1%and 98.1%,respectively.Compared with TCT and HR-HPV detection,in the diagnosis of HSIL and above lesions,while ensuring the sensitivity,Improve specificity,positive predictive value,negative predictive value.Conclusion:P16/Ki-67 double staining provides a more objective diagnostic basis for the diagnosis of cervical HSIL and above lesions,improves the accuracy of HSIL and above cervical lesions,and reduces unnecessary missed diagnoses and misdiagnosis.
作者
凡琳琳
陈俊忠
梁嘉杰
Fan Linlin(Department of Pathology,The Sixth Affiliated Hospital of South China University of Technology(Nanhai District People’s Hospital of Foshan City),Foshan,Guangdong 528000)
出处
《黑龙江医药》
CAS
2023年第1期47-50,共4页
Heilongjiang Medicine journal
基金
佛山市卫生和计生局医学科研项目(编号:20190283)。
