中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
43期
3040-3044
,共5页
马袁英%叶枫%陈晓端%邱丽倩%吕卫国%谢幸
馬袁英%葉楓%陳曉耑%邱麗倩%呂衛國%謝倖
마원영%협풍%진효단%구려천%려위국%사행
P16%人乳头瘤病毒%宫颈肿瘤%子宫颈上皮内瘤变
P16%人乳頭瘤病毒%宮頸腫瘤%子宮頸上皮內瘤變
P16%인유두류병독%궁경종류%자궁경상피내류변
P16%Human papillomavirus%Cervix neoplasm%CIN
目的 探讨子宫颈(简称宫颈)脱落细胞中P16INK4α(P16)表达预测宫颈高级别病变的准确性.方法 对192例宫颈薄层液基细胞剩余标本液,采用免疫组化方法检测P16表达,同时行高危人乳头瘤病毒(HPV)检测,并以阴道镜下组织病理学检查结果为金标准,比较P16检测、宫颈细胞学检查和高危HPV检测预测宫颈高级别病变的准确性.结果 (1)正常组织、子宫颈上皮内瘤变(CIN)1、CIN 2、CIN 3和CA患者宫颈脱落细胞P16阳性表达率分别为16.3%、46.7%、93.8%、91.1%、100.0%.通过Spearman相关分析显示宫颈脱落细胞中P16阳性表达率与其组织学病变呈正相关,r=0.900,P＜0.05;(2)宫颈脱落细胞P16检测预测宫颈高级别病变的敏感性、特异性、阳性预测值、阴性预测值,准确率分别为94.1%、78.5%、77.7%、94.4%、85.4%;高危HPV检测(HC2)的敏感性、特异性、阳性预测值、阴性预测值、准确率分别为95.3%、56.1%、63.3%、93.8%、73.4%;宫颈细胞学检查的敏感性、特异性、阳性预测值、阴性预测值,准确率分别为82.4%、92.5%、89.7%、86.8%、88.0%;通过卡方检验显示宫颈脱落细胞P16检测特异性、阳性预测值和准确率高于高危HPV检测(P＜0.05),宫颈脱落细胞P16相比细胞学检查准确性差异无统计学意义(P＞0.05).结论 在宫颈癌筛查中,宫颈脱落细胞P16检测特异性、阳性预测值和准确率优于高危HPV检测.P16具有预测宫颈高级别病变的价值.
目的 探討子宮頸(簡稱宮頸)脫落細胞中P16INK4α(P16)錶達預測宮頸高級彆病變的準確性.方法 對192例宮頸薄層液基細胞剩餘標本液,採用免疫組化方法檢測P16錶達,同時行高危人乳頭瘤病毒(HPV)檢測,併以陰道鏡下組織病理學檢查結果為金標準,比較P16檢測、宮頸細胞學檢查和高危HPV檢測預測宮頸高級彆病變的準確性.結果 (1)正常組織、子宮頸上皮內瘤變(CIN)1、CIN 2、CIN 3和CA患者宮頸脫落細胞P16暘性錶達率分彆為16.3%、46.7%、93.8%、91.1%、100.0%.通過Spearman相關分析顯示宮頸脫落細胞中P16暘性錶達率與其組織學病變呈正相關,r=0.900,P＜0.05;(2)宮頸脫落細胞P16檢測預測宮頸高級彆病變的敏感性、特異性、暘性預測值、陰性預測值,準確率分彆為94.1%、78.5%、77.7%、94.4%、85.4%;高危HPV檢測(HC2)的敏感性、特異性、暘性預測值、陰性預測值、準確率分彆為95.3%、56.1%、63.3%、93.8%、73.4%;宮頸細胞學檢查的敏感性、特異性、暘性預測值、陰性預測值,準確率分彆為82.4%、92.5%、89.7%、86.8%、88.0%;通過卡方檢驗顯示宮頸脫落細胞P16檢測特異性、暘性預測值和準確率高于高危HPV檢測(P＜0.05),宮頸脫落細胞P16相比細胞學檢查準確性差異無統計學意義(P＞0.05).結論 在宮頸癌篩查中,宮頸脫落細胞P16檢測特異性、暘性預測值和準確率優于高危HPV檢測.P16具有預測宮頸高級彆病變的價值.
목적 탐토자궁경(간칭궁경)탈락세포중P16INK4α(P16)표체예측궁경고급별병변적준학성.방법 대192례궁경박층액기세포잉여표본액,채용면역조화방법검측P16표체,동시행고위인유두류병독(HPV)검측,병이음도경하조직병이학검사결과위금표준,비교P16검측、궁경세포학검사화고위HPV검측예측궁경고급별병변적준학성.결과 (1)정상조직、자궁경상피내류변(CIN)1、CIN 2、CIN 3화CA환자궁경탈락세포P16양성표체솔분별위16.3%、46.7%、93.8%、91.1%、100.0%.통과Spearman상관분석현시궁경탈락세포중P16양성표체솔여기조직학병변정정상관,r=0.900,P＜0.05;(2)궁경탈락세포P16검측예측궁경고급별병변적민감성、특이성、양성예측치、음성예측치,준학솔분별위94.1%、78.5%、77.7%、94.4%、85.4%;고위HPV검측(HC2)적민감성、특이성、양성예측치、음성예측치、준학솔분별위95.3%、56.1%、63.3%、93.8%、73.4%;궁경세포학검사적민감성、특이성、양성예측치、음성예측치,준학솔분별위82.4%、92.5%、89.7%、86.8%、88.0%;통과잡방검험현시궁경탈락세포P16검측특이성、양성예측치화준학솔고우고위HPV검측(P＜0.05),궁경탈락세포P16상비세포학검사준학성차이무통계학의의(P＞0.05).결론 재궁경암사사중,궁경탈락세포P16검측특이성、양성예측치화준학솔우우고위HPV검측.P16구유예측궁경고급별병변적개치.
Objective To explore the value of P16 in the predication of high-grade cervical intraepithelial (HGCIN) by P16 expression in cervical specimens. Methods One hundred ninety-two residual ThinPrep samples were collected and detected by HPV DNA test and P16 detected by immunocytochemistry. All women underwent colposcopy and histological examination of biopsy specimen if needed. P16 test, cytology and HR-HPV DNA (HC2) test were compared based on histological examination of colposcopic biopsies. Results (1)The expression of P16 showed 16.3% in normal or inflammatory cases, 46. 7% in CIN 1,93. 8% in CIN 2, 91.1% in CIN 3 and 100. 0% in carcinoma. A positive relation between P16 and the grade of cervical lesions was observed by Spearman analysis ( P ＜ 0. 05, r = 0. 900).(2)By P16 test, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for ≥CIN 2 were 94. 1%, 78.5% , 77.7%, 94.4% and 85.4% respectively. By HR-HPV DNA test, the sensitivity, specificity, PPV, NPV and accuracy for ≥ CIN 2 were 95.3%,56. 1%, 63. 3%, 93. 8% and 73.4% respectively. By cytological test, the sensitivity, specificity, PPV,NPV and accuracy for ≥ CIN 2 were 82.4%, 92. 5%, 89. 7%, 86. 8% and 88.0% respectively. There were significant difference of specificity, PPV and accuracy between P16 and HR-HPV DNA ( P ＜ 0. 05 ).And no significant difference of accuracy was found between P16 and cytology( P ＞ 0. 05). Conclusion The specificity, PPV and accuracy of P16 are significantly higher than those of HR-HPV DNA. Thus P16 test is valuable to diagnose HGCIN in ThinPrep specimens.
