HPV阳性女性中宫颈液基细胞学、DNA倍体分析及P16/Ki-67双染检测对宫颈癌前病变的分流效果研究

A Study on the Triage Effect of Cervical Liquid-based Cytology,DNA Ploidy Analysis,and P16/Ki-67 Dual Staining in Cervical Precancerous Lesions in HPV-positive Women

目的探讨在HPV阳性女性中,液基细胞学、DNA倍体分析及P16/Ki-67双染检测对宫颈癌前病变的分流作用。方法回顾性分析2021年5月至2022年12月在我院妇科行阴道镜及宫颈活检的妇女590例。患者高危人乳头瘤病毒(human papilloma virus,HPV)检测阳性,且行液基细胞学(liquid-based cytology,LBC)、DNA倍体分析、P16/Ki-67双染3种检查,对上述3种方法的灵敏度、特异性、受试者工作特征(receiver operating characteristic,ROC)曲线进行统计分析。结果液基细胞学、DNA倍体分析和P16/Ki-67双染3种筛查方法对宫颈癌前病变的灵敏度分别为84.2%、77.5%、76.4%,特异性分别为40.7%、49.2%、70.1%,曲线下面积(area under the curve,AUC)分别是0.625、0.634、0.733,其中,P16/Ki-67双染检测显著优于液基细胞学检查及DNA倍体分析(P<0.0001)。结论本研究认为,在HPV阳性女性中,P16/Ki-67双染检测的分流效果最佳。

Objective To investigate the triage effect of liquid-based cytology,DNA ploidy analysis,and P16/Ki-67 dual-stain immunohistochemistry in HPV-positive women with cervical precancerous lesions.Methods A retrospective analysis was conducted on 590 women who underwent vaginal colposcopy and cervical biopsy at our hospital from May,2021 to December,2022.All patients tested positive for high-risk human papillomavirus(HPV)and underwent three examinations:liquid-based cytology(LBC),DNA ploidy analysis,and P16/Ki-67 dual-stain.The sensitivity,specificity,and receiver operating characteristic(ROC)curves of the three methods were statistically analyzed.Results The sensitivities of liquid-based cytology,DNA ploidy analysis,and P16/Ki-67 dual-stain for cervical precancerous lesions were 84.2%,77.5%,and 76.4%,respectively,while the specificities were 40.7%,49.2%,and 70.1%,respectively.AUCs were 0.625,0.634,and 0.733,respectively.Among them,P16/Ki-67 dual-stain was significantly superior to LBC and DNA ploidy analysis(P<0.0001).Conclusion This study suggests that P16/Ki-67 dual-stain has the best triage effect in HPV-positive women.