p 16/Ki 67双染在宫颈病变患者筛查中的价值

Value of p 16/Ki 67 double staining in screening cervical lesions

目的探究p16/Ki67免疫染色在宫颈病变患者筛查中的价值。方法选择2017年1月至2020年1月在深圳市宝安区福永人民医院就诊的宫颈病变患者80例为研究对象,采集细胞标本进行p16/Ki67双染和人乳头瘤病毒(HPV)检测,计算两种检测方法在宫颈病变诊断中的敏感性和特异性。结果80例研究对象中p16/Ki67检测显示阳性者共45例,意义不明的不典型鳞状细胞(ASC-US)、不能排除高度上皮内病变的不典型鳞状上皮(ASC-H)、低度鳞状上皮内病变(LSIL)和高度鳞状上皮内病变(HSIL)分级患者中p16/Ki67阳性比例分别为45.76%(27/59)、75.00%(3/4)、85.71%(12/14)和100.00%(3/3),宫颈病变越严重,p16/Ki67检测阳性率越高(P<0.05);HPV阳性共54例,ASC-US、ASC-H、LSIL和HSIL分级患者中HPV阳性比例分别为66.10%(39/59)、50.00%(2/4)、71.43%(10/14)和100.00%(3/3),不同宫颈病变分级患者的HPV阳性率间差异无统计学意义(P>0.05);p16/Ki67双染诊断LSIL及以上病变的敏感性为88.24%,特异性为52.38%,HPV检测的敏感性为76.47%,特异性为34.92%,p16/Ki67和HPV检测的敏感性间差异无统计学意义(P>0.05),特异性间差异有统计学意义(P<0.05)。结论p16/Ki67阳性率与宫颈病变程度有关,p16/Ki67染色对宫颈癌病变诊断的敏感性和特异性较高,临床上可用于宫颈癌筛查的辅助诊断,值得推广应用。

【Objective】To explore the value of p 16/Ki 67 immunostaining in screening cervical lesions.【Methods】Eighty patients with cervical lesions in our hospital from January 2017 to January 2020 were selected as the research objects.Cell samples were collected for p 16/Ki 67 double staining and HPV detection,and the sensitivity and specificity of the two detection methods in the diagnosis of cervical lesions were calculated.【Results】There were 45 cases of p 16/Ki 67 positive,and the positive rates of p 16/Ki 67 in ASC-US,ASC-H,LSIL and HSIL were 45.76%(27/59),75.00%(3/4),85.71%(12/14)and 100.00%(3/3),respectively.The more serious the cervical lesions,the higher the positive rate of p 16/Ki 67(P<0.05).There were 54 cases of HPV positive,and HPV positive in ASC-US,ASC-H,LSIL and HSIL was 66.10%(39/59),50.00%(2/4),71.43%(10/14)and 100.00%(3/3),respectively.There was no significant difference in the positive rate of HPV among patients with different grades of cervical lesions(P>0.05).The sensitivity and specificity of p 16/Ki 67 double staining in the diagnosis of LSIL and above lesions were 88.24%,52.38%,which were 76.47%,34.92%of HPV detection.There was no significant difference in the sensitivity(P>0.05),but there was significant difference in the specificity between p 16/Ki 67 and HPV detection(P<0.05).【Conclusion】The positive rate of p 16/Ki 67 is related to the degree of cervical lesions.The sensitivity and specificity of p 16/Ki 67 staining in the diagnosis of cervical cancer is high.It can be used in the auxiliary diagnosis of cervical cancer screening in clinical practice,which is worthy of promotion and application.