阴道镜联合肿瘤抑制基因P16、增殖细胞核抗原Ki-67免疫组化染色对宫颈上皮内瘤变分级的诊断价值

Diagnostic Value of Colposcopy Combined with Multiple Tumor Suppressor 16 and Proliferating Cell Nuclear Antigen Ki-67 Immunohistochemical Staining in Grading Cervical Intraepithelial Neoplasia

目的:探讨阴道镜联合肿瘤抑制基因P16(P16)、增殖细胞核抗原Ki-67免疫组化染色在宫颈上皮内瘤变(CIN)分级诊断中的应用价值.方法:选取2022年1月至2022年10月期间本院收治的高度疑似CIN患者40例为研究对象.所有患者均行阴道镜及P16、Ki67免疫组化染色,并以穿刺活检病理检查结果为标准,统计分析诊断CIN分级的准确度及一致性.结果:病理检查结果显示,40例患者炎症反应为10例,CIN分级Ⅰ级为10例,Ⅱ级为9例,Ⅲ级为6例,宫颈癌为5例.阴道镜联合P16、Ki-67免疫组化染色诊断CIN分级的准确度高于各检查单独应用(P<0.05).阴道镜检查结果与金标准一致性一般(Kappa=0.683,P<0.05);P16、Ki-67免疫组化染色及联合诊断结果与金标准一致性强(Kappa=0.873、0.968,P均<0.05).结论:阴道镜联合P16、Ki-67免疫组化染色在CIN分级诊断中的价值显著.

Objective:To explore the role of colposcopy combined with Multiple tumor suppressor 16(P16)and proliferating cell nuclear antigen Ki-67 immunohistochemical staining in cervical intraepithelial neoplasia(CIN)grading diagnosis.Methods:A total of 40 highly suspected CIN patients admitted to our hospital from January 2022 to October 2022 were selected as the research subjects.Colposcopy and immunohistochemical staining of P16 and Ki67 were performed in all patients,and the accuracy of CIN classification was statistically analyzed and its consistency was analyzed based on the results of puncture biopsy pathology.Results:Among the 40 patients,10 cases of inflammation,10 cases of CIN I,9 cases of CIN II,6 cases of CIN II and 5 cases of cervical cancer were confirmed by biopsy pathology.Colposcopy combined with P16 and Ki-67 immunohistochemical staining was more accurate in diagnosing CIN classification than colposcopy,P16 and Ki-67 immunohistochemical staining alone(P<0.05).The results of colposcopy were generally consistent with those of pathology(Kappa=0.638,P<0.05).The results of P16 and Ki-67 immunohistochemical staining and combined diagnosis of CIN were consistent with the results of pathological examination(Kappa=0.873 and 0.968,P<0.05).Conclusion:Colposcopy combined with P16 and Ki-67 immunohistochemical staining is of significant value in the classification of CIN.