临床与病理杂志2023，Vol.43Issue(10)：1793-1800,8.DOI:10.11817/j.issn.2095-6959.2023.230174
p16/Ki-67双染对比液基细胞学及HPV DNA检测在宫颈癌早期筛查中的价值
Value of p16/Ki-67 dual staining contrast liquid-based cytology and HPV DNA detection in early screening for cervical cancer
摘要
Abstract
Objective:Liquid-based cytology(LBC)and human papilloma virus(HPV)DNA detection have important significance in early screening for cervical lesions,but they exhibit some limitations in clinical practice.p16/Ki-67 dual staining is an emerging detection method.This study explores the characteristics of p16/Ki-67 dual staining detection compared to LBC and HPV DNA detection in early screening for cervical lesions. Methods:A total of 292 patients diagnosed with chronic cervicitis,low-grade squamous intraepithelial lesion(LSIL),high-grade squamous intraepithelial lesion(HSIL)and above(HSIL+),confirmed by histology and undergoing LBC,HPV DNA detection,and p16/Ki-67 dual staining tests from July 2021 to July 2023 at the Maternal and Child Health Care Hospital of Zhengzhou were selected as the research subjects.Histopathology served as the gold standard for diagnosis.The differences in p16/Ki-67 dual staining among different biopsy grades and its triage in abnormal LBC results,HPV DNA detection-positive,and LBC-negative samples were analyzed.The diagnostic efficacy of the 3 methods in cervical lesions was compared and the receiver operator characteristic(ROC)curve was evaluated. Results:The concordance rate between intraepithelial lesion or malignancy(NILM)detected by LBC and biopsy results was 67.6%(119/176).Among patients with atypical squamous cells of undetermined significance(ASC-US),26.7%(20/75)had negative biopsies,and among LSIL and above lesions,22.0%(9/41)had negative biopsies.In HPV DNA detection-positive patients(including single HPV DNA detection-positive and combined LBC and p16/Ki-67 dual staining-positive),60.5%(135/223)had biopsies indicating LSIL and HSIL,while 39.5%(88/223)had negative biopsies.Among p16/Ki-67 dual staining-positive patients,70.4%(112/159)had biopsies indicating LSIL and HSIL,and 29.6%(47/159)had negative biopsies.Among the 3 detection methods,p15/Ki-67 dual staining had the highest concordance rate with biopsy results at 72.9%(213/292).For LSIL and above lesions,HPV DNA detection had the highest sensitivity at 93.8%,LBC had the highest specificity at 80.4%,and there was no statistically significant difference between the 3 methods of pairwise combined screening(all P>0.05).p16/Ki-67 dual staining had more guiding significance for true positive HPV DNA detection specimens than LBC;it had an advantage over HPV DNA detection in true negative LBC specimens,and there was also a statistically significant difference for specimens that were HPV DNA detection-positive but LBC-negative(P<0.05). Conclusion:The positive rate of p16/Ki-67 dual staining is correlated with the severity of cervical lesions.The combination of p16/Ki-67 dual staining with LBC or HPV DNA detection can effectively improve diagnostic accuracy when LBC and HPV DNA detection results are inconsistent.关键词
宫颈癌/上皮内病变/p16/Ki-67双染/液基细胞学/人乳头瘤病毒Key words
cervical cancer/intraepithelial neoplasia/p16/Ki-67 dual staining/liquid-based cytology/human papillomavirus引用本文复制引用
赵国红,李新敏,钱进,李健豪,师雅琳..p16/Ki-67双染对比液基细胞学及HPV DNA检测在宫颈癌早期筛查中的价值[J].临床与病理杂志,2023,43(10):1793-1800,8.基金项目
河南省医学科技攻关计划项目(LHGJ20210782,LHGJ20220883) （LHGJ20210782,LHGJ20220883）
河南省科技发展计划项目(222102310608).This work was supported by the Henan Medical Science and Technology Project(LHGJ20210782,LHGJ 20220883)and the Henan Provincial Science and Technology Development Plan(222102310608),China. （222102310608）
