Yu J, Zhu H T, Zhao J J, Su J Z, Xia Y D
Department of Pathology, First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 201204, China.
Zhonghua Bing Li Xue Za Zhi. 2017 May 8;46(5):323-326. doi: 10.3760/cma.j.issn.0529-5807.2017.05.008.
To investigate the sorting effect of p16(INK4a)/Ki-67 double immunostaining method in patients with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) cytology results. Four-hundred and twenty cases collected during April 2014 to February 2015 of cervical cytology of ASCUS (=318) and LSIL (=102) were selected, and residual liquid-based cytology specimens were used for p16(INK4a)/Ki-67 double immunostaining. The sensitivity and specificity of the detection of cervical precancerous lesions and cervical cancer were calculated, and the results were compared with high risk HPV. Taking histological follow-up as the gold standard, the test was considered positive when at least one cell exhibited p16(INK4a)/Ki-67 co-staining, without requirement of adjunct morphologic interpretation of positive cells. Further screening CIN2+ in cytology ASCUS and LSIL group , the sensitivity of p16(INK4a)/Ki-67 double immunostaining was slightly lower than high risk HPV (84.2% . 94.7%), while the specificity was higher (84.0% . 53.9%). For ASCUS patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 82.6% and 91.3%, and the specificity was 88.8% and 63.7%, respectively. For LSIL patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 86.7% and 100.0%, and the specificity was 67.8% and 20.7%, respectively. For patients younger and older than 30 years, specificity of p16(INK4a)/Ki-67 double immunostaining was both higher than that of high risk HPV (80.8% . 42.3%; 84.6% . 56.9%). p16(INK4a)/Ki-67 double immunostaining can effectively identify the high risk population in ASCUS or LSIL, with higher specificity than high risk HPV test. p16(INK4a)/Ki-67 double immunostaining may benefit patients younger than 30 years of age as a preliminary or potential cytology-combining screening tool.
探讨p16（INK4a）/Ki-67双重免疫染色法对意义不明确的非典型鳞状细胞（ASCUS）或低度鳞状上皮内病变（LSIL）细胞学结果患者的分流效果。选取2014年4月至2015年2月期间收集的420例ASCUS（=318）和LSIL（=102）宫颈细胞学病例，并将剩余的液基细胞学标本用于p16（INK4a）/Ki-67双重免疫染色。计算检测宫颈癌前病变和宫颈癌的敏感性和特异性，并将结果与高危型人乳头瘤病毒（HPV）检测结果进行比较。以组织学随访为金标准，当至少一个细胞出现p16（INK4a）/Ki-67共染色时，该检测被视为阳性，无需对阳性细胞进行辅助形态学解释。在细胞学ASCUS和LSIL组中进一步筛查CIN2+，p16（INK4a）/Ki-67双重免疫染色的敏感性略低于高危型HPV（84.2%对94.7%），而特异性较高（84.0%对53.9%）。对于ASCUS患者，p16（INK4a）/Ki-67双重免疫染色和高危型HPV的敏感性分别为82.6%和91.3%，特异性分别为88.8%和63.7%。对于LSIL患者，p16（INK4a）/Ki-67双重免疫染色和高危型HPV的敏感性分别为86.7%和100.0%，特异性分别为67.8%和20.7%。对于年龄小于和大于30岁的患者，p16（INK4a）/Ki-67双重免疫染色的特异性均高于高危型HPV（80.8%对42.3%；84.6%对56.9%）。p16（INK4a）/Ki-67双重免疫染色可有效识别ASCUS或LSIL中的高危人群，其特异性高于高危型HPV检测。p16（INK4a）/Ki-67双重免疫染色作为一种初步或潜在的联合细胞学筛查工具，可能对30岁以下的患者有益。
