P16/Ki-67双染、TCT细胞学、HPV联合检测技术在宫颈病变筛查中的应用价值分析

摘要/Abstract

摘要： 目的探讨与分析P16/Ki-67双染、液基薄层细胞学检查（Thinprep Cytologic Test,TCT）、人乳头状瘤病毒（Human Papilloma Virus,HPV）联合检测技术在宫颈病变筛查中的应用价值。方法收集2022年4月—2023年4月选择在酒钢医院自愿行宫颈病变筛查且后期进行宫颈组织活检的83例就诊人群为研究对象,所有人群都给予P16/Ki-67双染、TCT细胞学、HPV联合检测,分别记录检测阳性情况。同时所有人群都进行了病理组织检查,并以此为诊断金标准,判断诊断价值。结果在83例患者中,病理检查为正常组织21例、CIN 1级47例、CIN 2级12例、CIN 3级3例,其中高级别上皮内瘤变占18.07%。83例患者中,正常组织、CIN 1级、CIN 2级、CIN 3级患者的P16/Ki-67双染、TCT细胞学、HPV联合检测阳性率分别为4.76%、10.64%、66.67%、66.67%。P16/Ki-67双染、TCT细胞学、HPV检查单独检测与联合检测对宫颈病变的诊断敏感性分别为66.67%（10/15）、66.67%（10/15）、100.00%（15/15）、66.67%（10/15）,诊断特异性分别为91.18%（62/68）、60.29%（41/68）、17.65%（12/68）、91.18%（62/68）。结论 P16/Ki-67双染、TCT细胞学、HPV联合检测技术能更准确地发现潜在的高级别病变患者,提高宫颈病变检出率,有很好的应用价值。

关键词: P16/Ki-67双染, 液基薄层细胞学检查, 人乳头状瘤病毒, 联合检测, 宫颈病变, 敏感性, 特异性

Abstract: Objective To explore and analysis the application values of P16/Ki-67 double staining, thinprep cytological test (TCT) and human Papilloma (HPV) combined detection technology in screening cervical lesions. Methods From April 2022 to April 2023, 83 cases patients who voluntarily underwent cervical lesion screening and cervical tissue biopsy at our hospital's gynecological outpatient and inpatient clinics were collected as the study subjects. All patients received P16/Ki-67 double staining, TCT cytology, and HPV combined testing, and their positive results were recorded. At the same time, all populations underwent pathological tissue examinations and used them as the diagnostic gold standard to determine the diagnostic value. Results In the 83 patients, pathological examination showed 14 cases of normal tissue, 54 cases of CIN grade 1, 12 cases of CIN grade 2, and 3 cases of CIN grade 3, with high-grade intraepithelial neoplasia accounting for 18.07%. The combined positive rates of normal tissue, CIN 1, CIN 2, and CIN 3 were 4.76%, 10.64%, 66.67%, and 66.67%, respectively. The diagnostic sensitivity of P16/Ki-67 double staining, TCT cytology, and HPV examination for cervical lesions was 66.67% (10/15), 66.67% (10/15), 100.00% (15/15), and 66.67% (10/15), respectively. The diagnostic specificity was 91.18% (62/68), 60.29% (41/68), 17.65% (12/68), and 91.18% (62/68), respectively. Conclusion The P16/Ki-67 double staining, TCT cytology, and HPV combined detection technology can more accurately detect potential high-level lesions in patients, improve the detection rate of cervical lesions, and have good application value.

Key words: P16/Ki-67 double staining, liquid based thin layer cytology, human papilloma virus, joint testing, cervical lesions, sensitivity, specificity

中图分类号:

R365

胡红霞. P16/Ki-67双染、TCT细胞学、HPV联合检测技术在宫颈病变筛查中的应用价值分析[J]. 中华养生保健, 2024, 42(1): 4-7.

HU Hong-xia. Analysis of the Application Value of P16/Ki-67 Double Staining, TCT Cytology, and HPV Combined Detection Technology in Cervical Lesion Screening[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(1): 4-7.

参考文献

[1] KONISHI M, FUJITA M, SHIMABUKURO K, et al.Predictive Factors of Late Cervical Lymph Node Metastasis Using Intraoral Sonography in Patients With Tongue Cancer[J]. Anticancer Res,2022,42(1):287-292.
[2] 高丽丽,李青.p16/Ki-67手工染色与全自动免疫组化仪染色效果对比[J].临床与实验病理学杂志,2022,38(1):113-114.
[3] BUZA N.Immunohistochemistry in gynecologic carcinomas: Practical update with diagnostic and clinical considerations based on the 2020 WHO classification of tumors[J]. Semin Diagn Pathol,2022,39(1):58-77.
[4] 徐海沧,胡沙沙,耿守孟,等.p16/Ki-67双染在宫颈癌筛查分流中的应用价值[J].诊断病理学杂志,2022,29(7):614-619.
[5] 祁昔琴,刘婷婷,朱伦.宫颈脱落细胞p16/Ki-67双染联合DNA定量分析在宫颈癌筛查中的临床价值[J].中国临床研究,2022,35(2):172-176.
[6] 孙笑非,顾依群,王爱春,等.细胞块p16/Ki-67双染对子宫颈炎患者宫颈上皮内瘤变的诊断价值[J].中华实验和临床感染病杂志(电子版),2022,16(6):418-425.
[7] 崔焱,张瑜英,潘琳.宫颈疾病患者p16/Ki-67表达状况及其与HPV感染的相关性[J].川北医学院学报,2022,37(4):494-496,500.
[8] 吴艳,王瑾,解浩然,等.高危型HPV分型、TCT、P16/Ki-67双染在宫颈癌筛查中的价值[J].中国计划生育学杂志,2022,30(12):2875-2879.
[9] 高燕,杨红,张晓红,等.人乳头瘤病毒、液基薄层细胞学及DNA倍体联合筛查在宫颈癌患者诊断的临床价值[J].实用医院临床杂志,2021,18(6):36-38.
[10] 武振宇. FIS1 mRNA、HPV E6/E7 mRNA 表达水平与宫颈病变严重程度的关系研究[J].中国实验诊断学,2023,27(1):63-67.
[11] 周晋星,赵莎,吴妍,等.子宫颈TCT联合细胞蜡块免疫标记诊断恶性淋巴瘤的临床病理学分析[J].临床与实验病理学杂志,2023,39(3):350-352.
[12] 冯慧敏,张海凤,孙永红,等.HPV E6/E7mRNA原位杂交技术在HPV分型检测阴性的子宫颈腺癌中的研究[J].实用妇产科杂志,2023,39(2):154-157.
[13] 颜梅,温生宝,王雪燕,等.动态对比增强MRI参数联合纹理分析对宫颈癌细胞增殖活性的评估价值[J].实用放射学杂志,2023,39(3):428-432.
[14] 东静静,王文立,杜晓静,等.阴道镜下p16/细胞增殖核抗原双染、人乳头瘤病毒L1衣壳蛋白半定量PU值与宫颈上皮内瘤变演化关系及对高级别病变的评估价值[J].中国性科学,2023,32(3):83-87.
[15] 薛桐,陈奎生,韦娜,等.TCT联合p16/Ki-67双染、HPV E6/E7 mRNA检测在宫颈鳞状上皮内病变中的诊断价值[J].郑州大学学报(医学版),2023,58(3):391-394.
[16] 刘敏,缪华珍,黄菁.G蛋白偶联受体4、Ki-67、生存素与高危HPV感染的相关性及诊断宫颈癌价值[J].中国计划生育学杂志,2022,30(12):2866-2869,2874.
[17] 魏晓强,刘丽丽,孙贤华,等.Periostin和Ki67在宫颈癌中的表达及其与预后的关系[J].徐州医科大学学报,2022,42(3):225-230.
[18] 关小米,韩笑笑,刘丽雅,等.子宫颈高级别神经内分泌癌临床病理及预后分析[J].实用妇产科杂志,2022,38(11):857-862.
[19] 李翠平,郑明雪,董江宁,等.基于MR T2WI的纹理分析术前预测宫颈鳞癌Ki-67表达水平的研究[J].实用放射学杂志,2022,38(5):786-790,800.
[20] 陈静,颜红丽,王超,等.T3期子宫内膜癌的MRI影像表现及其与ER、PR、C-erbB-2及Ki-67表达的关系研究[J].现代生物医学进展,2022,22(19):3785-3789.