摘要
目的:探讨薄层液基细胞学检测(TCT)联合P16免疫细胞染色检查在宫颈癌前病变筛查中的价值。方法:以2019年5月至10月在本院就诊的108例患者为研究对象,收集宫颈脱落细胞,应用免疫组化检测P16表达;应用薄层液基细胞学筛查(TCT)对脱落细胞进行宫颈癌筛查;在阴道镜下对可疑病变区进行多点病理活组织取样,进行病理学诊断。以病理组织学检查结果为金标准,比较TCT、P16及两者联合检测对宫颈癌前病变筛查的灵敏度、特异度和准确度等指标。结果:TCT检测的灵敏度、特异度和准确度分别为85.53%、90.63%及87.04%,TCT检测结果与病理学诊断结果一致性较好(Kappa=0.71)。P16检测的灵敏度、特异度和准确度分别为67.11%、93.75%及75%,P16检测与病理诊断结果一致性一般(Kappa=0.51),但P16特异性高并且对高级别CIN病变灵敏度高。TCT+P16联合检测的灵敏度、特异度和准确度分别为94.74%、84.38%及91.67%;联合检测结果与病理学诊断结果高度一致(Kappa=0.798),与P16或TCT单独检测结果比较,差异有统计学意义(均P<0.005)。结论:TCT和P16联合检测可提高宫颈癌前病变早期筛查的灵敏度和准确度,对宫颈癌的早期防治有重要临床价值。
Objective To determine the value of Thinprep cytologic test(TCT)combined with P16 immunostaining in screening of precancerous cervical lesions.Methods A total of 108 patients who visited our hospital between May and October of 2019 were included as the study subjects.Cervical exfoliated cells were collected from these patients.Immunohistochemistry was used to detect the P16 expression.TCT was used to examine the exfoliated cells for purpose of cervical cancer screening.Multiple biopsy specimens of suspicious lesions were obtained under colposcopy for pathological diagnosis.Using histopathological findings as the gold standard,the sensitivity,specificity and accuracy of TCT and P16,used alone or in combination for screening precancerous cervical lesions,were calculated and evaluated.Results The sensitivity,specificity and accuracy of TCT was 85.53%,90.63%and 87.04%,respectively,showing good agreement with pathological diagnosis(Kappa=0.71).The sensitivity,specificity and accuracy of P16 was 67.11%,93.75%and 75%,respectively,showing modest consistency with pathological diagnosis(Kappa=0.51).Despite this,P16 detection yielded high overall specificity and a good sensitivity to high-grade CIN lesions.The sensitivity,specificity and accuracy of TCT combinated with P16 was 94.74%,84.38%and 91.67%,respectively,showing high consistency with the pathological diagnosis(Kappa=0.798),with statistically significant difference compared with P16 or TCT alone(all P<0.005).Conclusion TCT combined with P16 detection can improve the sensitivity and accuracy of early screening for precancerous cervical lesions,suggesting important clinical value for early prevention and treatment of cervical cancer.
作者
李美波
晁远
宋安辉
蔡双
叶健威
黄志娴
Li Meibo;Chao Yuan;Song Anhui;Cai Shuang;Ye Jianwei;Huang Zhixian(Department of Pathology,Huizhou Sixth People’s Hospital,Huizhou,Guangdong 316200,China;Department of Gynecology,Huizhou Sixth People’s Hospital,Huizhou,Guangdong 316200,China)
出处
《中华生物医学工程杂志》
CAS
2021年第1期19-24,共6页
Chinese Journal of Biomedical Engineering
基金
惠州市科技计划项目(2019Y283)。
关键词
薄层液基细胞学检测
P16
宫颈肿瘤
宫颈癌前病变
Thinprep cytologic test
P16
Uterine cervical neoplasms
Precancerous cervical lesions
