评估p16免疫细胞化学在醋酸肉眼检查筛查呈阳性的女性中检测CIN2+的作用。
To Evaluate the Role of p16 Immunocytochemistry for Detection of CIN2+ in Women Detected Screen Positive by Visual Inspection Using Acetic Acid.
作者信息
Verma Lalita, Shamsunder Saritha, Malik Sunita, Arora Rashmi
机构信息
Department of Obstetrics and Gynaecology, Vardhmaan Mahaveer Medical College and Safdarjung Hospital, New Delhi, India.
Department of Pathology, Vardhmaan Mahaveer Medical College and Safdarjung Hospital, New Delhi, India.
出版信息
J Cytol. 2020 Apr-Jun;37(2):82-86. doi: 10.4103/JOC.JOC_89_18. Epub 2020 Apr 14.
OBJECTIVE
To evaluate the role of p16 immunostaining for the detection of cervical intraepithelial neoplasia (CIN2+) in women who had a positive screening test using visual inspection with acetic acid (VIA).
METHODS
Opportunistic screening of women (30-50 years) coming to the gynecology clinic by VIA was performed; the screen-positive women were included in the study which had the institutional review board (IRB) approval. A cytology slide for p16 immunostaining, colposcopy, and biopsy was then performed sequentially. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of p16 immunocytochemistry were evaluated with histopathology as the gold standard.
RESULTS
p16 positivity showed a linear correlation with the increasing grade of CIN. p16 positivity was seen in 6% of CIN 1, 80% of CIN 2, 100% of CIN 3, and squamous cell carcinoma. The sensitivity and specificity of p16 immunocytochemistry for detecting CIN 2 or more was 87.5% (95%CI 61.65-98.45) and 97.06% (95%CI 84.67-99.93). Colposcopy had an equal sensitivity of 87.5% (95% CI 61.65-98.45) and specificity of 50% (95% CI 32.43-67.57), respectively.
CONCLUSION
With high sensitivity and specificity, p16 immunocytochemistry could be a viable option for triaging VIA-positive women.
目的
评估p16免疫染色在醋酸肉眼观察法（VIA）筛查结果为阳性的女性中检测宫颈上皮内瘤变（CIN2+）的作用。
方法
对到妇科门诊就诊的30至50岁女性进行VIA机会性筛查；筛查结果为阳性的女性纳入本研究，本研究获得了机构审查委员会（IRB）的批准。随后依次进行用于p16免疫染色的细胞学涂片、阴道镜检查和活检。以组织病理学为金标准，评估p16免疫细胞化学的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
结果
p16阳性与CIN分级增加呈线性相关。在6%的CIN 1、80%的CIN 2、100%的CIN 3和鳞状细胞癌中可见p16阳性。p16免疫细胞化学检测CIN 2及以上病变的敏感性和特异性分别为87.5%（95%CI 61.65-98.45）和97.06%（95%CI 84.67-99.93）。阴道镜检查的敏感性同样为87.5%（95%CI 61.65-98.45），特异性分别为50%（95%CI 32.43-67.57）。
结论
p16免疫细胞化学具有高敏感性和特异性，可作为对VIA阳性女性进行分流的可行选择。
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