Dovnik Andraž, Repše Fokter Alenka
University Clinic for Gynecology and Perinatology, University Medical Center Maribor, Maribor, Slovenia.
Department for Pathology and Cytology, General Hospital Celje, Celje, Slovenia.
J Low Genit Tract Dis. 2020 Jul;24(3):235-237. doi: 10.1097/LGT.0000000000000539.
The interpretation of postmenopausal smears and the gynecological treatment of these patients can often be difficult. The objective of this study was to assess the performance of p16/Ki-67 dual-stained cytology as a triage of atypical squamous cells of undetermined significance and low-grade intraepithelial lesion cytology results in postmenopausal women.
All consecutive atypical squamous cells of undetermined significance and low-grade intraepithelial lesion smears in 1-year period were collected and p16/Ki-67 immunostaining was performed retrospectively. The results were compared with histology results or long-term cytology follow-up in cases with no biopsy.
The sensitivity of p16/Ki-67 immunostaining for the detection of cervical intraepithelial neoplasia (CIN) 2 and CIN 3 was 57.1% and 85.0%, respectively. The specificity for the detection of CIN 2 was 94.3% and CIN 3 92.4%. Negative predictive values for the detection of CIN 2 and CIN 3 were 96.3% and 99.6%, respectively.
Dual p16/Ki-67 immunostaining is a useful additional method in postmenopausal patients with low-grade cytology. Considering the high specificity and negative predictive value in our study, we believe that it could be helpful in avoiding unnecessary referrals to colposcopy and thus reduce the cost of the program.
对绝经后涂片进行解读以及对这些患者进行妇科治疗往往存在困难。本研究的目的是评估p16/Ki-67双重染色细胞学作为绝经后妇女意义不明确的非典型鳞状细胞和低级别上皮内病变细胞学结果分流方法的性能。
收集1年内所有连续的意义不明确的非典型鳞状细胞和低级别上皮内病变涂片，并回顾性进行p16/Ki-67免疫染色。将结果与组织学结果或未进行活检病例的长期细胞学随访结果进行比较。
p16/Ki-67免疫染色检测宫颈上皮内瘤变（CIN）2和CIN 3的敏感性分别为57.1%和85.0%。检测CIN 2的特异性为94.3%，检测CIN 3的特异性为92.4%。检测CIN 2和CIN 3的阴性预测值分别为96.3%和99.6%。
p16/Ki-67双重免疫染色是绝经后低级别细胞学患者的一种有用的辅助方法。考虑到我们研究中的高特异性和阴性预测值，我们认为它有助于避免不必要的阴道镜检查转诊，从而降低该项目的成本。
