Performance of P16/Ki67 dual staining in triaging hr-HPV-positive population during cervical Cancer screening in the younger women
Performance of P16/Ki67 dual staining in triaging hr-HPV-positive population during cervical Cancer screening in the younger women
复制标题
P16/Ki67 双重染色在年轻女性宫颈癌筛查期间对 hr-HPV 阳性人群进行分类的表现
DOI：
10.1016/j.cca.2018.05.023
复制
发表时间：
2018-08-01
影响因子：
5
通讯作者：
Shen, Yang
中科院分区：
文献类型：
--
作者：
Qian, Qiu-Ping;Zhang, Xiaoan;Shen, Yang
背景：宫颈癌是女性生殖道最常见的恶性肿瘤，通常由低级别或高级别鳞状上皮内病变（LSIL或HSIL）发展而来。在lsil - hsil -侵袭性癌症后遗症期间发现癌前病变，可有效阻断肿瘤的发生，降低侵袭性癌的发生率。本研究的目的是评估P16/Ki67双染色在hr- hpv阳性人群的鉴别中的作用。方法：对所有患者进行常规妇科检查、宫颈细胞学检查和hr-HPV检测。采集标本进行细胞学检查和HPV基因分型。根据细胞学结果将患者分为宫颈癌组、HSIL组、LSIL组和良性病变组。比较双染色法在各病理组的敏感性和特异性。结果：参与研究的108例患者中，经组织病理学检查，正常65例，低级别鳞状细胞癌15例，HSIL 20例，CC 8例。细胞学标本p16/Ki67双染色阳性预测值为86%，阴性预测值为96%。ThinPrep细胞学检测（TCT）与双染色联合检测HSIL的灵敏度为96.43%，特异性为60%。TCT和p16/Ki67双染色联合检测在所有尝试的检测方法组合中特异性最高。结论：p16/Ki-67双染色是宫颈癌筛查的有效方法。应用该方法可减少不必要的阴道镜检查转诊和误诊。
Background: Cervical cancer is the most common malignancy from the female reproductive tract, and usually develops from low-grade or high-grade squamous intraepithelial lesions (LSIL or HSIL). Detecting the precancerous lesion during the LSIL-HSIL-invasive cancer sequelae can effectively interrupt the oncogenesis and decrease the incidence of invasive carcinoma. The aim of this study is to evaluate the performance of P16/Ki67 dual staining in triaging hr-HPV-positive population.Methods: Conventional gynecological examination, cervical cytology and hr-HPV testing were given to all patients. Specimens were collected for cytology examination and HPV genotyping. According to cytology results, patients were divided into cervical cancer group, HSIL group, LSIL group and benign lesion group. Sensitivity and specificity of the dual staining method in each histopathologic group was obtained and compared.Results: Among the 108 patients participated in the study, 65 were diagnosed as normal, 15 as LSIL, 20 as HSIL and 8 as CC, by histopathologic examination. Dual staining of p16/Ki67 on cytology specimen provided a positive predictive value of 86% and the negative predictive value of 96%. The sensitivity approached 96.43% when combining ThinPrep cytological test (TCT) with the dual staining, with a specificity of 60% in detecting HSIL. Joint detection of TCT and p16/Ki67 dual staining displayed the highest specificity among all the attempted combinations of detection methods.Conclusions: This study demonstrated that p16/Ki-67 dual staining represents an effective method for cervical cancer screening. Application of this method could lead to a reduction of unnecessary colposcopy referrals and misdiagnosis.