North Bristol NHS Trust, Bristol, England.
Am J Clin Pathol. 2010 Jul;134(1):12-21. doi: 10.1309/AJCP3CD9YKYFJDQL.
We analyzed the performance of p16(INK4a) immunocytochemistry on a series of 810 retrospectively collected atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) cases with available biopsy follow-up data, including 94 cases of cervical intraepithelial neoplasia (CIN) 2 and 128 cases of CIN 3. Human papillomavirus (HPV) testing was performed from the same residual liquid-based cytologic specimen, and results for both tests were correlated with histologic follow-up data. Sensitivity values for high-grade CIN (HGCIN) confirmed on biopsy within 6 months were 92.6% (ASC-US) and 92.2% (LSIL) for cytotechnologists' reviews of p16 cytology and 90.1% (ASC-US) and 95.7% (LSIL) for HPV testing. Sensitivity rates of initial pathologists' reviews were slightly lower, 76.4% to 80.1%, with levels comparable to cytotechnologists' results after adjudication. The specificity of p16 cytology for HGCIN detection was significantly higher than for HPV testing for cytotechnologists and pathologists: 63.2% to 71.1% (p16 cytology) vs 37.8% for HPV in ASC-US (P < .001) and 37.3% to 53.3% (p16 cytology) vs 18.5% for HPV in LSIL (P < .001). This evaluation of the diagnostic performance of p16 cytology confirms the potential of this stain for the efficient triage of ASC-US and LSIL cytologic results.
我们分析了 p16(INK4a)免疫细胞化学在 810 例回顾性收集的非典型鳞状细胞意义不明确（ASC-US）和低度鳞状上皮内病变（LSIL）病例中的表现，这些病例均有可获得的活检随访数据，包括 94 例宫颈上皮内瘤变（CIN）2 级和 128 例 CIN 3 级。从同一剩余的液基细胞学标本中进行了人乳头瘤病毒（HPV）检测，两种检测的结果均与组织学随访数据相关。在 6 个月内通过活检证实的高级别 CIN（HGCIN）的敏感性值为细胞学技术员对 p16 细胞学的审查分别为 92.6%（ASC-US）和 92.2%（LSIL），HPV 检测分别为 90.1%（ASC-US）和 95.7%（LSIL）。初始病理学家审查的敏感性率略低，为 76.4%至 80.1%，经裁决后与细胞学技术员的结果相当。p16 细胞学对 HGCIN 检测的特异性明显高于 HPV 检测，对于细胞学技术员和病理学家来说，分别为 63.2%至 71.1%（p16 细胞学）与 ASC-US 中的 HPV 为 37.8%（P<.001），37.3%至 53.3%（p16 细胞学）与 LSIL 中的 HPV 为 53.3%（P<.001）。这项对 p16 细胞学诊断性能的评估证实了该染色剂对 ASC-US 和 LSIL 细胞学结果进行有效分流的潜力。
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