P16/Ki67双染对HPV1618阳性且TCT阴性患者宫颈病变的预警作用

Preventive Effect of Double Staining of P16/Ki67 on Cervical Lesions in Patients with HPV16 and HPV18 Positive and TCT Negative

目的:探讨p16/细胞增殖核抗原(Ki67)双染检测应用于TCT阴性且HPV16、18阳性患者宫颈病筛查的可行性。方法:收集2016年3月至2018年1月就诊于本院妇科液基薄层细胞学检查(TCT)结果为阴性但HPV16、HPV18检测呈阳性的患者100例为研究对象,均于TCT检查后6周内行p16/Ki67双染检测和阴道镜病理活检,以活检结果为金标准,分析p16/Ki67双染检测对筛查宫颈病变的敏感性和特异性。结果:病理活检结果显示宫颈上皮内瘤变2级以上(CIN2+)患者39例(39.00%),宫颈腺癌1例(1.00%),CIN3 21例(21.00%),CIN2 17例(17.00%)。以病理活检结果为金标准,p16/Ki67双染检测筛查CIN2+宫颈病变的敏感度为89.74%、特异度为96.72%、阳性预测值为94.59%、阴性预测值为93.65%。结论:p16/Ki67双染检测对CIN2+宫颈病变的筛选敏感度、特异度高,可用于宫颈病变的早期筛查,具有一定预警作用。

Objective:To explore the feasibility of p16/ cell proliferating nuclear antigen(Ki67)double staining test for cervical disease screening in TCT negative combined HPV16 and HPV18 positive patients.Methods:A total of 100 patients with negative TCT results but positive HPV16 and HPV18 tests were collected from March 2016 to January 2018.Both p16/Ki67 double staining and colposcopic pathological biopsy were performed within 6 weeks after TCT.The sensitivity and specificity of p16/Ki67 double staining for screening cervical lesions were analyzed based on the gold standard of biopsy results.Results:Pathological biopsy showed cervical intraepithelial neoplasia over grade 2(CIN2+)were 39 cases(39.00%),including 1 case of cervical adenocarcinoma(1.00%),21 cases of CIN3(21.00%),17 cases of CIN2(17.00%).The result of pathological biopsy was as the gold standard,the sensitivity of p16/Ki67 double staining test for screening CIN2+ cervical lesions was 89.74%,the specificity was 96.72%,the positive predictive value was 94.59%,the negative predictive value was 93.65%.Conclusion:P16/Ki67 double staining test has high sensitivity and specificity for screening CIN2+ cervical lesions,it can be used for early screening of cervical lesions,and has a certain early warning effect.