目的 探讨p16/Ki67双染检测在分流宫颈低度鳞状上皮内病变/高度鳞状上皮内病变 (LSIL/HSIL) 及预测LSIL转归中的临床意义.方法 收集2015年2月至2016年5月廉江市人民医院与湛江中心人民医院组织学证实为宫颈炎、LSIL、HSIL和宫颈癌的4组标本 (分别是102例、75例、68例、59例) 为研究对象, 回顾性分析前期细胞学标本的p16/Ki67双染检测结果, 观察4组研究对象的细胞学、组织学诊断结果中p16/Ki67双染结果的差异, 统计分析p16/Ki67双染检测诊断HSIL及以上 (简称HSIL+, 包括HSIL和宫颈癌) 的效能.并对确诊的75例LSIL患者随访2年, 分析p16/Ki67双染检测结果与LSIL转归的关系.结果 (1) 宫颈细胞学结果为未见上皮内瘤变及恶性病变 (NILM) 、意义不明的非典型鳞状细胞 (ASCUS) 、LSIL、ASU-H+ (包括ASU-H、高级别鳞状上皮内瘤变、鳞状细胞癌) 组的p16/Ki67双染阳性率分别为8.79％、41.67％、58.57％、91.57％, 总体差异有统计学意义 (P0.008) 外, 其余组两两之间比较, p16/Ki67双染阳性率差异均有统计学意义 (P0.008) 外, 其余组两两之间比较, p16/Ki67双染阳性率差异均有统计学意义 (P0.008) , but there was statistically significant difference in the positive rate of p16/Ki67 between the other two groups (P0.008) , but there was significant difference in the positive rate of p16/Ki67 between the other two groups (P<0.008) . (3) The sensitivity, specificity, coincidence rate, positive predictive value and negative predictive value of p16/Ki67 for diagnosing HSIL+ lesion were91.34％, 82.49％, 86.18％, 78.91％ and 92.99％ respectively. (4) The lesion progression rate of LSIL patients with p16/Ki67 double staining positive was 5.28 times higher than that of LSIL patients with p16/Ki67 double staining negative, the difference between them was statistically significant (P<0.05) .Conclusion The positive rate of p16/Ki67 double staining is constantly increased with the aggravation of cervical disease diagnostic results.The detection of p16/Ki67 has a certain significance in diagnosing HSIL+ lesions, shunting LSIL/HSIL and predicting the outcome of LSIL, which is worthy of being clinically promoted and applied.
展开▼
