p16/Ki-67双染检测在宫颈上皮内瘤变2级及以上病变中的应用

Application of p16/Ki-67 dual staining in Grade 2 cervical intraepithelial neoplasia and above

目的观察p16/Ki-67双染检测在宫颈上皮内瘤变(CIN)2级及以上病变中的应用。方法采集参加宫颈癌筛查和确诊为CIN2+的430名妇女宫颈标本,用高危人乳头瘤病毒(HR-HPV)、液基细胞学和p16/Ki-67双染等3种检测方法分析,比较其敏感性、特异性、阳性结果分数和转诊率等数据。结果在430名受检者中,p16/Ki-67双染的整体测试阳性率(33.0%)与HR-HPV(35.8%)、液基细胞学(36.3%)比较差异均无统计学意义(P>0.05),且随着疾病的严重程度逐渐增加;与HR-HPV阴性相比,HPV16/18阳性和其他12种类型HR-HPV阳性组的p16/Ki-67表达更高。p16/Ki-67检测CIN2+的敏感性为90.91%,与HR-HPV和液基细胞学的敏感性相当,但高于液基细胞学。结论p16/Ki-67双染技术具有较好的疾病确定性,可作为宫颈癌筛查的辅助方法。

Objective To observe the application of p16/Ki-67 dual staining in Grade 2 cervical intraepithelial neoplasia(CIN)and above.Methods The cervical specimens of 430 women who participated in cervical cancer screening and were diagnosed with CIN2+were collected.Three detection methods including the high-risk human papillomavirus(HR-HPV),liquid-based cytology,and p16/Ki-67 dual staining were used for the analysis of the above specimens,and the sensitivity,specificity,positive result score and referral rate were compared among the three different screening methods.Results Among 430 subjects,the overall positive rate of p16/Ki-67 dual staining(33.0%)had no statistical difference with HR-HPV(35.8%)and liquid-based cytology(36.3%),and increased significantly with the aggravation of the disease(P>0.05).Compared with HR-HPV negative,subjects with HPV16/18 positive and other 12 types of HR-HPV positive had a higher expression of p16/Ki-67.The sensitivity of p16/Ki-67 in the detection of CIN2+was 90.91%,and similar to HR-HPV and liquid-based cytology,but higher than liquid-based cytology.Conclusion The p16/Ki-67 dual staining technique has good disease certainty,and can be used as an auxiliary method for cervical cancer screening.