p16/Ki-67双染和高危型HPV检测在高级别鳞状上皮内病变的应用

p16/Ki-67 dual stain cytology and HR-HPV detection in screening CIN 2/3 diagnosed as ASCUS or LSIL

目的探讨p16/Ki-67细胞学双染和高危型HPV(HR-HPV)检测在宫颈高级别病变中的应用价值。方法ASCUS和LSIL患者295例,行HR-HPV检测、p16/Ki-67细胞学双染、阴道镜下活检,比较p16/Ki-67双染与HPV检测的敏感性和特异性。结果ASCUS和LSIL中,p16/Ki-67双染阳性率分别为37.4%和36.4%;病理活检诊断CIN 2/3的阳性率均为25.8%。p16/Ki-67分流CIN 2/3病例的敏感性84.2%,特异性79.5%,HPV分流CIN 2/3病例的敏感性90.8%,特异性64.8%。结论p16/Ki-67细胞学双染与HPV检测相比敏感性相仿,特异性明显提高。p16/Ki-67双染与病理学活检有较高的符合率,提高了宫颈癌筛查的准确率。

Purpose To investigate the diagnostic value of p16/Ki-67dual stain cytology and HR-HPV detection of cervical precancer as a novel option for cervical lesions screening. Methods A total of 295 cases diagnosed as ASCUS and LSIL were selected between 2014 December and 2016 July from the First Hospital of Harbin. Double staining of p16/ Ki-67 cytology, HPV testing, vaginal biopsy, biopsy and pathological examination were applicated, p16/Ki-67dual stain cytology was compared with that HPV detection of sensitivity and specificity. Results The positive rate of p16/Ki-67 dual stain cytology were 37. 42% and 36. 36% in ASCUS and LSIL, respectively. The positive rates of CIN 2/3 were 25.77% and 25.76% from biopsy, both having a high rate of compliance. The sensitivity of the p16/Ki-67 test for detecting CIN 2/3 was 83.33% , and the specificity was 78.51%. The sensitivity of HPV test for detecting CIN 2/3 was 83.33% , and the specificity was 78.51%. Conclusions The double staining of P16/Ki-67 is similar sensitivity to that of HPV, and the specificity of the shunt is significantly increased. The coincidence rate between p16/Ki-67 cytology and biopsy is higher, p16/Ki-67 double stain detection can effectively split the high grade cervical lesions in TCT and improve the accuracy of cervical cancer screening.