Public Health School of Central South University, Xiangya Road 110, 410078 Changsha, Hunan Province, China.
Med Oncol. 2011 Dec;28 Suppl 1:S547-52. doi: 10.1007/s12032-010-9705-y. Epub 2010 Nov 4.
The objective of this study is to detect the infection of human papillomavirus (HPV) and the expression of p16(INK4a) in cervical lesions and to investigate the interaction between hrHPV and p16(INK4a) for cervical lesions and its diagnostic efficiency. hrHPV-DNA was detected by the hybrid capture II (HC-II) system. Immunochemical method was used to detect the expression of p16(INK4a), and histopathologic test was performed to identify cervical lesions. χ(2) test and Spearman's rank correlation were used for statistical analysis. Additive effects model was used to analyze the interaction. The diagnostic sensitivity, specificity, positive predictive values, negative predictive values, accuracy, and the area under the receiver operating characteristic curve were calculated with SPSS 13.0. hrHPV and p16(INK4a) positive rate increased (P < 0.05) with histopathologic diagnosis increasing. The positive rates of hrHPV and p16(INK4a) in negative or chronic inflammation were statistically lower than that in cervical intraepithelial neoplasia (CIN)1, CIN2, CIN3, and squamous-cell carcinoma (SCC) (P < 0.05), respectively. There was a positive interaction between hrHPV and p16(INK4a), relative excess risk of interaction (RERI) was 52.49, attributable proportions of interaction (API) were 72.34%, and the synergy index (S) was 3.75. The specificity and AUC of combining hrHPV with p16(INK4a) were statistically higher than hrHPV or p16(INK4a) alone (P < 0.05). hrHPV and p16(INK4a) are useful markers for the early diagnosis of cervical lesions. A positive interaction between hrHPV and p16(INK4a) is seen. The combination of hrHPV and p16(INK4a) has a higher diagnostic accuracy than hrHPV or p16(INK4a) alone in diagnosis of cervical lesions.
本研究旨在检测人乳头瘤病毒（HPV）感染和宫颈病变中 p16(INK4a)的表达，探讨 HPV 和 p16(INK4a)在宫颈病变中的相互作用及其诊断效率。采用杂交捕获 II（HC-II）系统检测 HPV-DNA，免疫化学方法检测 p16(INK4a)的表达，组织病理学检查确定宫颈病变。采用卡方检验和 Spearman 等级相关进行统计学分析，采用相加模型分析交互作用。采用 SPSS 13.0 计算诊断灵敏度、特异度、阳性预测值、阴性预测值、准确率和受试者工作特征曲线下面积。随着组织病理学诊断的增加，HPV 和 p16(INK4a)的阳性率增加（P<0.05）。HPV 和 p16(INK4a)在阴性或慢性炎症中的阳性率显著低于 CIN1、CIN2、CIN3 和鳞状细胞癌（SCC）（P<0.05）。HPV 和 p16(INK4a)之间存在正交互作用，交互超额相对危险度（RERI）为 52.49，交互归因比例（API）为 72.34%，协同指数（S）为 3.75。HPV 和 p16(INK4a)联合检测的特异度和 AUC 均显著高于 HPV 或 p16(INK4a)单独检测（P<0.05）。HPV 和 p16(INK4a)是宫颈病变早期诊断的有用标志物。HPV 和 p16(INK4a)之间存在正交互作用。HPV 和 p16(INK4a)联合检测在宫颈病变诊断中的准确性高于 HPV 或 p16(INK4a)单独检测。
