Jia M M, Zhao D M, Guo Z, Wu Z N, Chen P P, Guo P P, Sun X Y, Zhang S K
Department of Gynecological Oncology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
Department of Pathology, Henan Cancer Hospital/Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Feb 6;54(2):192-197. doi: 10.3760/cma.j.issn.0253-9624.2020.02.015.
This study aimed to evaluate the clinical performance of p16/Ki-67 dual staining for triage high risk HPV (HR-HPV) infected women. Target objects were women who infected HR-HPV and received colposcopy examination between April and December of 2016 at the Second Affiliated Hospital of Zhengzhou University. Gynecologists collected the cervical exfoliated cells from eligible women for p16/Ki-67 dual staining, LBC testing and HPV DNA testing. Histology diagnosis were used as gold standard. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs) of p16/Ki-67 dual staining, LBC testing and HPV16/18 testing for triage of HR-HPV positive population were calculated and compared. A total of 295 HR-HPV infected women were selected, and the mean age was (44.29±11.48) years old. Positive rates of p16/Ki-67 dual staining, HPV16/18 testing and LBC testing were 70.17% (207), 56.95% (168) and 85.76% (253), respectively. When CIN2+as the endpoint, among the three triage methods, sensitivity of p16/Ki-67 dual staining was 90.00% (95: 85.06%-93.43%), higher than the value of HPV 16/18 testing, but lower than the value of LBC testing. Specificity, PPV and NPV of p16/Ki-67 dual staining were the highest [71.58% (95: 61.81%-79.67%), 86.96% (95:81.69%-90.88%) and 77.27% (95: 67.49%-84.78%)]. When detection for CIN3+, sensitivity of p16/Ki-67 dual staining was 92.90% (95: 87.74%-95.99%), lower than the value of LBC testing, but higher than the value of HPV16/18 testing. Specificity of p16/Ki-67 dual staining was 55.00% (95: 46.74%-63.00%), lower than the value of HPV16/18 testing, but higher than the value of LBC testing. PPV of p16/Ki-67 dual staining was 69.57% (95: 62.99%-75.43%), lower than the value of HPV 16/18 testing, but higher than the value of LBC testing. NPV of p16/Ki-67 dual staining was 87.50% (95: 78.99%-92.87%), higher than value of HPV 16/18 testing, but lower than the value of LBC testing. p16/Ki-67 dual staining has better clinical effects than HPV 16/18 testing and LBC testing for triage women with HR-HPV infection.
本研究旨在评估p16/Ki-67双重染色对高危型人乳头瘤病毒(HR-HPV)感染女性进行分流的临床性能。研究对象为2016年4月至12月期间在郑州大学第二附属医院感染HR-HPV并接受阴道镜检查的女性。妇科医生收集符合条件女性的宫颈脱落细胞进行p16/Ki-67双重染色、液基薄层细胞学检测(LBC)和HPV DNA检测。组织学诊断作为金标准。计算并比较p16/Ki-67双重染色、LBC检测和HPV16/18检测对HR-HPV阳性人群进行分流的敏感度、特异度、阳性预测值(PPV)和阴性预测值(NPV)。共选取295例HR-HPV感染女性,平均年龄为(44.29±11.48)岁。p16/Ki-67双重染色、HPV16/18检测和LBC检测的阳性率分别为70.17%(207例)、56.95%(168例)和85.76%(253例)。以CIN2+为终点时,在三种分流方法中,p16/Ki-67双重染色的敏感度为90.00%(95%置信区间:85.06%-93.43%),高于HPV 16/18检测的值,但低于LBC检测的值。p16/Ki-67双重染色的特异度、PPV和NPV最高[分别为71.58%(95%置信区间:61.81%-79.67%)、86.96%(95%置信区间:81.69%-90.88%)和77.27%(95%置信区间:67.49%-84.78%)]。以CIN3+为检测终点时,p16/Ki-67双重染色的敏感度为92.90%(95%置信区间:87.74%-95.99%),低于LBC检测的值,但高于HPV16/18检测的值。p16/Ki-67双重染色的特异度为55.00%(95%置信区间:46.74%-63.00%),低于HPV16/18检测的值,但高于LBC检测的值。p16/Ki-67双重染色的PPV为69.57%(95%置信区间:62.99%-75.43%),低于HPV 16/18检测的值,但高于LBC检测的值。p16/Ki-67双重染色的NPV为87.50%(95%置信区间:78.99%-92.87%),高于HPV 16/18检测的值,但低于LBC检测的值。对于HR-HPV感染女性的分流,p16/Ki-6