国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2010, Vol. 29 ›› Issue (4): 256-258.

• 论著 • 上一篇    下一篇

宫颈液基细胞P16、Ki-67 诊断非典型鳞状细胞的价值

张建兰,柳晓春,秦艳,禤坚艳,王夷,黎彭敏,宋春林

  

  1. 528000 广东省佛山市妇幼保健院妇产科（张建兰， 柳晓春，禤坚艳，彭敏），病理科（秦艳，王夷黎），检验科（宋春林）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-07-15 发布日期:2010-07-15

Diagnosis Value of Liquid-based Cervical Cell P16, Ki-67 in Atypical Squamous Cells

ZHANG Jian-lan，
LIU Xiao-chun，QIN Yan，XUAN Jian-yan，WANG Yi-li，PENG Min，SONG Chun-lin   

  1. Department of Obstetrics and Gynecology，Foshan Maternal and Child Health Hospital，Foshan 528000，Guangdong Province, China（ZHANG Jian-lan，LIU Xiao-chun，XUAN Jian-yan，PENG Min)；Department of Pathology， Foshan Maternal and Child Health Hospital，Foshan 528000，Guangdong Province, China（QIN Yan, WANG Yi-li)；Department of Clinical Laboratory，Foshan Maternal and Child Health Hospital，Foshan 528000， Guangdong Province, China（SONG Chun-lin）
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-07-15 Online:2010-07-15

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摘要： 目的：探讨宫颈液基细胞P16 及Ki-67 诊断不能明确意义的非典型鳞状细胞（ASCUS）的
价值。方法：用免疫细胞化学染色法检测156 例液基细胞学诊断为ASCUS 患者的液基细胞学剩余标本
P16 及Ki-67 的表达情况，并行高危型人乳头瘤病毒（HPV）检测。以病理检查结果为“金标准”。结果：P16
和Ki-67 表达阳性率与病变程度均呈正相关（rs=0.685 和rs=0.713，均P<0.05)。高危型HPV 阳性率
（59.62%）高于P16、Ki-67 蛋白高表达率（32.05%和33.97%），差异有统计学意义（字2 分别为30.31 和
25.81，P<0.01）。P16、Ki-67 的免疫细胞化学染色检出宫颈上皮内瘤样病变（CIN）Ⅱ及以上病变的敏感度
和特异度分别为87.50％、93.75%和82.26%、81.45％，特异度均明显高于HPV 检测的48.39％（P<0.01）。
结论：应用免疫细胞化学染色检测P16 和Ki-67，较高危型HPV检测能更好地提高高级别CIN的检出率，
剔除ASCUS 中的良性病变，对临床具有指导意义。

关键词: 宫颈上皮内瘤样病变, 活组织检查, 免疫组织化学, Ki-67 抗原, 乳头状瘤病毒科

Abstract: Objective：To investigate diagnosis value of testing P16 and Ki-67 protein expression in
cervical atypical squamous cells undefined significance （ASCUS）. Methods：156 cases who suffered from
ASCUS were collected. Then tested and compared the expression of P16 and Ki-67 in the cervical cell of all
specimen by immunocytochemistry staining and high-risk human papillomavirus （HPV）by nucleic acid
amplification with fluorescence. Results：The positive expression rate of P16 and Ki-67 was positive correlated
with the severity of cervical disease（rs=0.685、rs=0.713，P约0.05）. High-risk HPV-positive rate（59.62%）is
higher than P16, Ki-67 high expression rate（32.5%、33.97%），there are significant difference（字2=30.31 and
25.81, P<0.01）. The sensitivity and specificity of P16，Ki-67 staining in immune cells detecting CIN 域and
above CIN 域lesions were 87.50%，93.75% and 82.26%，81.45%，respectively. The specificity of P16 and
Ki-67 testing in all groups were significantly higher than HPV testing （48.39%，P约0.01). Conclusions：
Detecting P16 and Ki-67 by immunocytotochemical staining had a higher detecting rate of high-evel CIN
compared with a high-risk type HPV testing. It can exclude benign lesions in ASCUS and has a great clinical
signification.

Key words: Cervical intraepithelial neoplasia, Biopsy, Immunohistochemistry, Ki-67 Antigen, Papillomaviridae