P16/Ki-67双染联合DNA倍体分析在ASCUS分流诊断中的应用价值

doi:10.3969/j.issn.1004-616x.2020.04.003

癌变·畸变·突变 ›› 2020, Vol. 32 ›› Issue (4): 264-268.doi: 10.3969/j.issn.1004-616x.2020.04.003

P16/Ki-67双染联合DNA倍体分析在ASCUS分流诊断中的应用价值

尹璐¹, 马成斌¹, 刘平¹, 张祎¹, 赵学军²

1. 上海市长宁区妇幼保健院妇产科, 上海 200051;
2. 上海市长宁区妇幼保健院病理科, 上海 200051

收稿日期:2019-11-11 修回日期:2020-06-17 出版日期:2020-07-31 发布日期:2020-08-01
通讯作者: 张祎,E-mail:m13661903705@163.com E-mail:m13661903705@163.com
作者简介:尹璐,E-mail:happyluyin@163.com。
基金资助:
上海市长宁区科学技术委员会项目（CNKW2016Y12）

Value of P16/Ki-67 double staining combined with DNA ploidy analysis in ASCUS shunt

YIN Lu¹, MA Chengbin¹, LIU Ping¹, ZHANG Yi¹, ZHAO Xuejun²

1. Department of Obstetrics and Gynecology, Changning Maternity and Child Healthcare Hospital of Shanghai, Shanghai 200051;
2. Department of Pathology, Changning Maternity and Child Healthcare Hospital of Shanghai, Shanghai 200051, China

Received:2019-11-11 Revised:2020-06-17 Online:2020-07-31 Published:2020-08-01

摘要/Abstract

摘要： 目的： 探讨P16/Ki-67双染联合DNA倍体分析在宫颈意义不明的不典型鳞状细胞（ASCUS）分流诊断中的应用价值。方法： 选取2016年12月-2018年8月上海市长宁区妇幼保健院收治的经液基细胞学（LCT）诊断为ASCUS的患者115例，同时行P16/Ki-67双染检测，DNA倍体分析，且以阴道镜病理活检结果为金标准。结果： 115例患者阴道镜病理活检结果提示，宫颈上皮瘤变2级及以上（CIN2+）45例，其中CIN2级20例，CIN3级23例，鳞癌2例；P16/Ki-67双染检测CIN2+的灵敏性、特异性、诊断符合率分别为77.8%、77.1%、77.4%；DNA倍体分析检测CIN2+的灵敏性、特异性、诊断符合率分别为71.1%、34.3%、48.7%，且DNA倍体阴性的细胞标本中P16/Ki-67双染检测结果均为阴性；DNA倍体分析联合P16/Ki-67双染检测CIN2+的灵敏性、特异性、诊断符合率分别为92.9%、71.4%、86.3%，其中诊断符合率明显高于单纯采用DNA倍体分析（P < 0.05）。结论： P16/Ki-67双染相较于DNA倍体分析检测CIN2+具有更高灵敏度和特异度，两者联合检测能有效提高准确率，可辅助用于ASCUS的分流诊断。

关键词: P16/Ki-67双染, DNA倍体分析, 不典型鳞状细胞, 诊断价值

Abstract: OBJECTIVE: To investigate the value of P16/Ki-67 double staining combined with DNA ploidy analysis in the atypical squamous cells of undetermined significance (ASCUS) shunt. METHODS: The valid cytological samples from 115 patients diagnosed as ASCUS in Changning Maternity and Child Healthcare Hospital of Shanghai,from December 2016 to August 2018,were collected from LCT test. P16/Ki-67 double staining and DNA ploidy analysis were tested at the same time. The gold standard was the pathological biopsy results of colposcopy. RESULTS: Pathological examination showed that there were 45 cases of cervical intraepithelial neoplasia 2 or above (CIN2+),including 20 cases of CIN2,23 cases of CIN3 and 2 cases of squamous cell carcinoma. Among the 115 patients,the sensitivity,specificity and diagnostic coincidence rate of CIN2+ by P16/Ki-67 double staining were 77.8%,77.1% and 77.4%,respectively;the sensitivity,specificity and diagnostic coincidence rate of CIN2+ by DNA ploidy analysis were 71.1%,34.3%,48.7%,respectively,and the P16/Ki-67 double staining test results were negative in the DNA ploidy negative cell samples. DNA ploidy analysis combined with P16/Ki-67 double staining detection found that the sensitivity, specificity, and diagnostic coincidence rate of CIN2+ were 92.9%,71.4%,86.3%,respectively,of which the diagnostic coincidence rate was significantly higher than that of DNA ploidy analysis alone (P < 0.05). CONCLUSION: P16/Ki-67 double staining has higher sensitivity and specificity than DNA ploidy analysis for CIN2+. In addition,combination of the two methods effectively improved the accuracy for the shunt diagnosis of ASCUS.

Key words: P16/Ki-67 double staining, DNA ploidy analysis, atypical squamous cells of undetermined significance, diagnostic value

中图分类号:

R711.74

尹璐, 马成斌, 刘平, 张祎, 赵学军. P16/Ki-67双染联合DNA倍体分析在ASCUS分流诊断中的应用价值[J]. 癌变·畸变·突变, 2020, 32(4): 264-268.

YIN Lu, MA Chengbin, LIU Ping, ZHANG Yi, ZHAO Xuejun. Value of P16/Ki-67 double staining combined with DNA ploidy analysis in ASCUS shunt[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2020, 32(4): 264-268.

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P16/Ki-67双染联合DNA倍体分析在ASCUS分流诊断中的应用价值

Value of P16/Ki-67 double staining combined with DNA ploidy analysis in ASCUS shunt

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