细胞增殖抗原ki-67用于宫颈病变筛查的研究

The study of cellular proliferous ki-67 antigen in screening cervical preinvasive lesion and cervical carcinoma

目的:研究细胞增殖抗原ki-67在筛查宫颈癌及癌前病变中的作用。方法:所有病例(150例)均行传统宫颈刮片、薄层液基涂片各两张,分别行巴氏染色和ki-67免疫组化染色,采用TBS诊断系统进行细胞学诊断,分为巴氏组、巴氏+ki-67组、TCT组、TCT+ki-67组,以阴道镜下病理活检的组织学诊断为标准,比较各种筛查方法的灵敏度、特异度、假阴性率、假阳性率、阳性预测值、阴性预测值等。结果:检测灵敏度:TCT+ki-67>TCT>巴氏>巴氏+ki-67。特异度:TCT+ki-67>巴氏>TCT>巴氏+ki-67。假阴性率:巴氏+ki-67>巴氏>TCT>TCT+ki-67。假阳性率:巴氏+ki-67>TCT>巴氏>TCT+ki-67。阳性预测值:TCT+ki-67>TCT>巴氏>巴氏+ki-67。阴性预测值:TCT+ki-67>TCT>巴氏>巴氏+ki-67。结论:联合应用液基涂片和ki-67免疫组化染色进行宫颈疾病筛查,其灵敏度、特异度、阳性预测值、阴性预测值均较单用细胞学高,而假阴性率、假阳性率均为最低,是较为理想的筛查方法。

Objective：To study the utility of ki-67 in screening cervical preinvasive lesion and cervical carcinoma.Methods：Total of 150 cases were taken two slides of conventional pap smear and thinprep cytology test to do papanicolaou staining and ki-67 immunohistochemical staining respectively.Compare them with the results of pathologic diagnosis following colposcope.Results：Sensitivity：TCT＋ki-67〉TCT〉CPS〉CPS＋ki-67.Specificity：TCT＋ki-67〉CPS〉TCT〉CPS＋ki-67.False-negative rate： CPS＋ki-67〉CPS〉TCT〉TCT＋ki-67.False-positive rate：CPS＋ki-67〉TCT〉CPS〉TCT＋ki-67.Positive predictive value：TCT＋ki-67TCTCPSCPS＋ki-67.Negative predictive value：TCT＋ki-67TCTCPSCPS＋ki-67.Conclusion：The combined use of thinprep cytology test with ki-67 immunohistochemical staining has higher sensitivity,specificity,positive predictive value and negative predictive value,but lower false-negative rate and false-positive rate.It＇s a better method in screening of cervicol cancer.