P16/Ki-67细胞学双染在TCT诊断为非典型鳞状细胞意义不明确(ASC-US)中的分流作用研究

目的:分析P16/Ki-67双染在TCT(Thinprep cytologic test)诊断为非典型鳞状细胞,意义不明确(Atypical Squamous Cells of Undetermined Significance,ASC-US)的患者分流中的作用。方法:选取2016年9月-2018年9月在我院经宫颈液基细胞学检查诊断为ASC-US的434例女性患者为研究对象,采用P16/Ki-67双染、高危型HPV(High-Risk human papillomavirus,HR-HPV)检测,对比二者与宫颈组织学活检结果的相关性,并分析二者在ASC-US患者分流中的作用。结果:P16/Ki-67细胞学双染法的敏感性为78.2%,特异性为79.2%,HR-HPV法的敏感性为33.5%,特异性为62.3%。P16/Ki-67细胞学双染法在年轻组患者中检出高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)及以上病变的敏感性为94.5%,特异性为85.7%;在年长组患者中敏感性为44.4%,特异性为74.3%。结论:P16/Ki-67细胞学双染作为一种临床应用简单、患者易于接受、价格相对低廉的生物学标志物,为宫颈癌的早期筛查提供了新的选择。同时,对于年轻患者,P16/Ki-67双染用于ASC-US的分流比HR-HPV检测具有更高的临床应用价值。

Clinical Value of P16/Ki-67 Dual-stained Cytology for the Triage of Women with Atypical Squamous Cell of Undetermined Significance

ABSTRACT Objective: To evaluate the clinical value of P16/Ki-67 cytology for triage of women with atypical squamous cell of undetermined significance(ASC-US). Methods: A total of 434 cases diagnosed as ASC-US from Sep.2016 to Sep.2018 in our hospital were selected. Dual -stained cytology of P16/Ki-67, high-risk human papillomavirus (HR-HPV) detection, vaginal biopsy were applicated. P16/Ki-67 were compared with HR-HPV detected and pathological biopsy. Results: The sensitivity of P16/Ki-67 dual-stained was 78.2%, the specificity was 79.2%, The sensitivity of HR-HPV was 33.5%, the specificity was 62.3%, The sensitivity of P16/Ki-67 dual-stained in the group age under 35 years old was 94.5%, the specificity was 85.7%, in the group age above 35 years old, the sensitivity was 44.4%, the specificity was 74.3%. Conclusion: P16/Ki-67 dual-stained provides a new option for the early screening of cervical cancer, for simple clinical application, more acceptable and relatively inexpensive. Meanwhile, it has higher clinical application value than HR-HPV detection, especially in women under 35 years old.