摘要
目的:探讨检测宫颈不典型鳞状细胞(ASCUS)涂片中P16INK4A的表达对宫颈高度病变的预测价值。方法:采用免疫细胞化学法检测P16INK4A在126例宫颈不典型鳞状细胞涂片中的表达,并与病理学及HPV分型检测结果进行比较。结果:126例ASCUS病理结果为:宫颈炎69例(54.8%);CINⅠ34例(27.0%);CINⅡ16例(12.7%);CINⅢ7例(5.6%)。126例ASCUS患者中P16在CINⅡ~Ⅲ组、宫颈炎与CINⅠ组的阳性率分别为82.6%、24.3%,差异有统计学意义(P<0.01);HPV在CINⅡ~Ⅲ组、宫颈炎与CINⅠ组的阳性率分别为78.3%、40.8%,差异有统计学意义(P<0.01)。126例ASCUS患者中,60例HPV检测阳性,66例阴性,P16在前者的阳性率为36.3%,在后者的阳性率为30.3%,差异无统计学意义(P>0.05)。126例ASCUS患者中,P16、HPV诊断CINⅡ~Ⅲ病变的敏感性分别为:82.6%、78.3%,差异无统计学意义(P>0.05);诊断CINⅡ~Ⅲ的特异性分别为75.7%、59.2%,差异有统计学意义(P<0.05)。结论:P16INK4A的表达与宫颈病变的发生、发展相关,与HPV感染无关。检测P16INK4A有利于鉴别出ASCUS中宫颈高度病变。
Objective: To explore the value of P16INK4Aexpression in atypical squamous cell of undetermined significance( ASCUS) smears in predicting high- grade cervical intraepithelial neoplasm( CIN). Methods: Immunocytochemical method was used to detect P16INK4Aexpression in 126 cases of ASCUS smears,and the results were compared with pathological and HPV typing results. Results:Pathological results: 69 patients( 54. 8%) were found with cervicitis,34 patients( 27. 0%) were found with CINⅠ,16 patients( 12. 7%)were found with CINⅡ,and 7 patients( 5. 6%) were found with CINⅢ. The positive rates of P16 in CINⅡ- Ⅲ group,cervicitis and CINⅠ group were 82. 6% and 24. 3%,respectively,there was statistically significant difference( P <0. 01). The positive rates of HPV in CINⅡ- Ⅲ group,cervicitis and CINⅠ group were 78. 3% and 40. 8%,respectively,there was statistically significant difference( P <0. 01). Among 126 ASCUS patients,60 patients were found with positive HPV and 66 patients were found with negative HPV; among 60patients with positive HPV,the positive rate of P16 was 36. 3%,among 66 patients negative HPV,the positive rate of P16 was 30. 3%,there was no statistically significant difference( P > 0. 05). The sensitivities of P16 and HPV in diagnosis of CINⅡ- Ⅲ were 82. 6% and78. 3%,respectively,there was no statistically significant difference( P > 0. 05); the specificities of P16 and HPV in diagnosis of CINⅡ-Ⅲ were 75. 7% and 59. 2%,respectively,there was statistically significant difference( P <0. 05). Conclusion: P16INK4Aexpression is correlated with occurrence and development of cervical lesions,which is not related to HPV infection. P16INK4Adetection is helpful to identification of high- grade CIN among patients with ASCUS.
出处
《中国妇幼保健》
CAS
北大核心
2014年第20期3330-3333,共4页
Maternal and Child Health Care of China
