p16/Ki-67双重染色法在宫颈不典型鳞状上皮细胞及低级别鳞状上皮内病变中的应用价值

Application value of p16/Ki-67 double staining in atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion

目的探讨p16/Ki-67双重染色法在宫颈不典型鳞状上皮细胞(ASCUS)及低级别鳞状上皮内病变(LSIL)中的应用价值。方法选取2022年9月至2023年9月江西景德镇第一人民医院收治的105例子宫颈病变患者作为研究对象,其中ASCUS患者52例,LSIL患者53例,均接受p16/Ki-67双重染色法、高危型人乳头瘤病毒(HR-HPV)检测,比较p16/Ki-67双重染色法与HR-HPV在ASCUS及LSIL中的阳性率、检出结果及诊断效能。结果105例子宫颈病变患者中p16/Ki-67双重染色法总阳性率为23.81%,其中ASCUS阳性率为11.54%,LSIL阳性率为35.85%,LSIL阳性率更高。52例ASCUS病例中,阴道镜活检确诊宫颈高级别病变4例,p16/Ki-67双重染色法诊断宫颈高级别病变特异度、准确度均高于HR-HPV。53例LSIL患者中,阴道镜活检确诊宫颈高级别病变9例,p16/Ki-67双重染色法诊断宫颈高级别病变特异度、准确度、AUC值均高于HR-HPV,差异有统计学意义(P<0.05)。结论相比ASCUS,p16/Ki-67双重染色法检测对LSIL的阳性检出率更高,且p16/Ki-67双重染色法检测能够提高对宫颈高级别病变诊断的特异度、准确度,具有较高的诊断价值。

Objective To investigate the application value of p16/Ki-67 double staining in the diagnosis of atypical squamous cells of undetermined significance(ASCUS)and low-grade squamous intraepithelial lesion(LSIL).Methods A total of 105 patients with cervical lesions admitted to Jingdezhen NO.1 People's Hospital from September 2022 to September 2023 were selected as the research objects,including 52 patients with ASCUS and 53 patients with LSIL,all of whom received p16/Ki-67 double staining and high risk human papilloma virus(HR-HPV)detection,compare the positive rate,detection results and diagnostic efficacy of p16/Ki-67 double staining and HR-HPV in ASCUS and LSIL.Results The total positive rate of p16/Ki-67 in 105 patients with cervical lesions was 23.81%,the positive rate of ASCUS was 11.54%,the positive rate of LSIL was 35.85%,and the positive rate of LSIL was higher.Among 52 cases of ASCUS,colposcopic biopsy confirmed high-grade cervical lesions in 4 cases,and the specificity and accuracy of p16/Ki-67 double staining in diagnosis of high-grade cervical lesions were higher than those of HR-HPV.Among the 53 LSIL cases,9 cases were diagnosed with high-grade cervical lesions by colinoscopic biopsy,and the specificity,accuracy and AUC value of p16/Ki-67 double staining in diagnosis of high-grade cervical lesions were higher than those of HR-HPV,with statistical significances(P<0.05).Conclusion Compared with ASCUS,p16/Ki-67 double staining detection has higher positive rate of LSIL,and p16/Ki-67 double staining detection can improve the specificity and accuracy of the diagnosis of high-grade cervical lesions,and has high diagnostic value.