p16/Ki67双重免疫细胞化学在检测宫颈腺癌中的应用

Utility of p16/Ki67 double immunocytochemistry for detection of cervical adenocarcinoma.

作者信息

Ryu Ayumi, Honma Keiichiro, Shingetsu Azusa, Tanada Satoshi, Yamamoto Takashi, Nagata Shigenori, Kamiura Shoji, Yamasaki Tomoyuki, Ohue Masayuki, Matsuura Nariaki

机构信息

Department of Oncology, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan.

Departments of Clinical Laboratory, Osaka International Cancer Institute, Osaka City, Osaka, Japan.

出版信息

Cancer Cytopathol. 2022 Dec;130(12):983-992. doi: 10.1002/cncy.22631. Epub 2022 Aug 17.

DOI:10.1002/cncy.22631

PMID:35976043

Abstract

BACKGROUND

Although the incidence of cervical adenocarcinoma has consistently increased, especially among young women, there is no established best means for screening. This study evaluated the screening efficacy of CINtec PLUS (CINtec; p16/Ki67 double immunocytochemistry) expression in cervical glandular cells.

METHODS

Cervical cytology was examined using abnormal glandular cells. The CINtec status of 100 samples with corresponding surgically resected specimens and 11 samples that exhibited negative results for intraepithelial lesion or malignancy at follow-up was analyzed. Additionally, 31 negative samples containing benign glandular cells were included.

RESULTS

Of the 142 samples, CINtec status was diffusely positive in 74, focally positive in 24, and negative in 44. The 74 diffusely positive samples included 70 adenocarcinomas (62 cervical, seven uterine, and one ovarian) and four cases of high-grade cervical intraepithelial neoplasia. The 24 focally positive samples included 15 adenocarcinomas (seven cervical, seven uterine, and one fallopian tube) and nine without malignancy. The 44 negative samples included nine adenocarcinomas (five uterine and four cervical) and 35 without malignancy. The sensitivity, specificity, positive predictive value, and negative predictive value of the CINtec diffusely or focally positive cases for cervical adenocarcinomas were 94.5%, 58.0%, 70.4%, and 90.9%, respectively. In CINtec diffusely positive cases, the respective values were 84.9%, 82.6%, 83.8%, and 83.8%, and in women aged ≤39 years the values were 90.6%, 89.5%, 93.5%, and 85.0%, respectively.

CONCLUSIONS

CINtec may support efficient detection of cervical adenocarcinomas.

摘要

背景

尽管宫颈腺癌的发病率持续上升，尤其是在年轻女性中，但目前尚无公认的最佳筛查方法。本研究评估了CINtec PLUS（CINtec；p16/Ki67双重免疫细胞化学）在宫颈腺细胞中的筛查效能。

方法

使用异常腺细胞检查宫颈细胞学。分析了100例有相应手术切除标本的样本以及11例随访时上皮内病变或恶性肿瘤结果为阴性的样本的CINtec状态。此外，还纳入了31例含有良性腺细胞的阴性样本。

结果

在142例样本中，CINtec状态为弥漫性阳性的有74例，局灶性阳性的有24例，阴性的有44例。74例弥漫性阳性样本包括70例腺癌（62例宫颈、7例子宫和1例卵巢）和4例高级别宫颈上皮内瘤变。24例局灶性阳性样本包括15例腺癌（7例宫颈、7例子宫和1例输卵管）和9例无恶性病变者。44例阴性样本包括9例腺癌（5例子宫和4例宫颈）和35例无恶性病变者。CINtec弥漫性或局灶性阳性病例对宫颈腺癌的敏感性、特异性、阳性预测值和阴性预测值分别为94.5%、58.0%、70.4%和90.9%。在CINtec弥漫性阳性病例中，相应的值分别为84.9%、82.6%、83.8%和83.8%，在年龄≤39岁的女性中，相应的值分别为90.6%、89.5%、93.5%和85.0%。