基于p16/ki67细胞学双染检测宫颈癌前病变的研究

A study on the detection of cervical precancerous lesions based on p16/ki67 cytology double staining

目的探讨p16/ki67细胞学双染检测在宫颈病变筛查中的应用价值。方法收集妇科宫颈病变门诊患者56例为研究对象,所有患者均行宫颈液基细胞学检查(TCT)、人乳头瘤状病毒(HPV)检测、阴道镜活检,并进行p16/ki67双染,分析比较双染与TCT、HPV检查诊断宫颈病变的效能,并研究p16/ki67双染诊断宫颈病变的价值。结果在细胞学为非侵入式负荷监测(NILM)、不典型鳞状细胞(ASC-US)、低级别鳞状上皮内病变(LSIL)以上病变的分级患者中p16/ki67双染阳性的比例分别是15.38%、66.67%、92%,不同宫颈组织学诊断结果中慢性宫颈炎、宫颈上皮内瘤变Ⅰ级(CINⅠ)、宫颈上皮内瘤变Ⅱ级(CINⅡ)和Ⅲ级(CINⅢ)的患者中p16/ki67双染阳性率分别为6.66%、75%、78.57%、100%,总体差异有统计学意义(P<0.05)。结论p16/ki67免疫细胞化学染色阳性率与宫颈癌前期病变的严重程度呈现正相关。P16/ki67双染较TCT和HPV提高了宫颈病变筛查的灵敏性和特异性,并提高了高级别鳞状上皮内病变(HSIL)的检出率,减少阴道镜的转诊率,值得应用于临床。

Objective To explore the application value of p16/ki67 cytology double staining in the screening of cervical lesions.Methods A total of 56 outpatients with gynecological cervical lesions were collected as the study subjects.All patients underwent TCT,HPV,biopsy,and p16/ki67 double staining,and the efficacy of double staining in diagnosing cervical lesions was analyzed and compared,and the value of p16/ki67 double staining in the diagnosis of cervical lesions was studied.Results The proportions of p16/ki67 double staining were 15.38%,66.67%,and 92%,respectively.The positive rates of p16/ki67 double staining in patients with chronic cervicitis,CINⅠ,CINⅡ,and CINⅢwere 6.66%,75%,78.57%,and 100%,respectively.The overall difference was statistically significant(P<0.05).Conclusion The positive rate of p16/Ki67 immunocytochemical staining is positively correlated with the severity of cervical precancerous lesions.p16/ki67 double staining improves the sensitivity and specificity of cervical lesion screening compared to TCT and HPV,and increases the detection rate of HSIL lesions and reduces the referral rate of colposcopy,which is very worthy of clinical application.