Das Diya, Sengupta Moumita, Basu Keya, Tirkey Mona, Datta Chhanda, Chatterjee Uttara
Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
J Cytol. 2018 Jul-Sep;35(3):153-158. doi: 10.4103/JOC.JOC_4_17.
Pap-smears-based cytology and human papilloma virus testing have their own limitations in detecting cervical precancerous lesions, and still need further standardization. Co-expression of p16 and Ki-67 can be used as additional biomarker.
To study the role of liquid-based cytology and the dual immunostaining for p16/Ki-67 in predicting the presence of significant lesion in cases of mild cytological atypia.
A prospective, cross-sectional study was performed in the Department of Pathology, in collaboration with Department of Obstetrics and Gynecology over 15 months including 545 patients. Immunocytochemistry followed by colposcopy-guided biopsy were performed in 52 cases with epithelial abnormalities.
Thirty-five cases (67%) were dual-stain positive among the cases with epithelial abnormalities. In the ASC-US and LSIL group, the sensitivity and specificity of the immunostaining in diagnosing CIN2+ lesions were 100 and 70% and 87.5 and 100%, respectively. p16/Ki-67 positivity also increased with cytological severity which in turn corresponded with histological findings: it reached from 33% in ASC-US to 100% in both HSIL and SCC categories.
This dual immunostaining may potentially be a useful tool in the triage of the ASC-US and the LSIL group, considering the high sensitivity and specificity values.
基于巴氏涂片的细胞学检查和人乳头瘤病毒检测在检测宫颈癌前病变方面都有其局限性，仍需进一步标准化。p16和Ki-67的共表达可作为额外的生物标志物。
研究液基细胞学检查以及p16/Ki-67双重免疫染色在预测轻度细胞学异型病例中显著病变存在情况时的作用。
在病理学系与妇产科合作下进行了一项为期15个月的前瞻性横断面研究，纳入545例患者。对52例上皮异常病例进行了免疫细胞化学检查，随后进行阴道镜引导下活检。
上皮异常病例中35例（67%）双重染色呈阳性。在非典型鳞状细胞不能明确意义（ASC-US）和低度鳞状上皮内病变（LSIL）组中，免疫染色诊断高级别鳞状上皮内病变（CIN2+）的敏感性和特异性分别为100%和70%以及87.5%和100%。p16/Ki-67阳性率也随着细胞学严重程度的增加而升高，这与组织学结果相对应：从ASC-US中的33%升至HSIL和鳞状细胞癌（SCC）类别中的100%。
考虑到高敏感性和特异性值，这种双重免疫染色可能是ASC-US和LSIL组分流中的一种有用工具。
