Dunton C J, van Hoeven K H, Kovatich A J, Oliver R E, Scacheri R Q, Cater J R, Carlson J A
Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Gynecol Oncol. 1997 Mar;64(3):451-5. doi: 10.1006/gyno.1996.4602.
The purpose of the work was to determine the feasibility and predictive value of Ki-67 immunostaining of cervical cytology and the detection of cervical dysplasia. Air-dried cervical smears were stained with MIB-1 antibody to identify the Ki-67 antigen. Nuclear decoration in abnormal squamous nuclei determined immunoreactivity. One hundred twenty-four nonpregnant patients underwent colposcopy and directed biopsies for abnormal cytology. Sensitivity (0.89), specificity (0.65), positive predictive value (0.60), and negative predictive value (0.91) were found for Ki-67 immunostaining in detection of high-grade cervical intraepithelial neoplasia (CIN) in 124 patients and positive Ki-67 staining was a significant predictor of high-grade CIN in both univariate (odds ratio 15.5 (95% CI 5.5-43.8) and multivariable (odds ratio 21.5 (95% CI 5.0-92.0) analysis. In 101 patients with ASCUS and LGSIL, Ki-67 immunostaining demonstrated the following in detection of high-grade CIN: sensitivity (0.96), specificity (0.67), positive predictive value (0.49), and negative predictive value (0.98). Ki-67 immunostaining of cervical cytology is a predictor of significant cervical pathology with high sensitivity and negative predictive value. Ki-67 immunostaining of cervical cytology may represent a new and cost-effective triage tool for patients with minor abnormalities on cytology.
这项工作的目的是确定宫颈细胞学Ki-67免疫染色的可行性和预测价值以及检测宫颈发育异常情况。将风干的宫颈涂片用MIB-1抗体染色以识别Ki-67抗原。异常鳞状细胞核中的核染色确定免疫反应性。124例非妊娠患者因细胞学异常接受了阴道镜检查及定向活检。在124例患者中，发现Ki-67免疫染色检测高级别宫颈上皮内瘤变（CIN）的敏感性为0.89、特异性为0.65、阳性预测值为0.60、阴性预测值为0.91，并且Ki-67染色阳性在单变量分析（比值比15.5（95%可信区间5.5 - 43.8））和多变量分析（比值比21.5（95%可信区间5.0 - 92.0））中均是高级别CIN的显著预测指标。在101例非典型鳞状细胞不能明确意义（ASCUS）和低度鳞状上皮内病变（LGSIL）患者中，Ki-67免疫染色检测高级别CIN的结果如下：敏感性为0.96、特异性为0.67、阳性预测值为0.49、阴性预测值为0.98。宫颈细胞学Ki-67免疫染色是具有高敏感性和阴性预测值的显著宫颈病变的预测指标。宫颈细胞学Ki-67免疫染色可能是细胞学有轻微异常患者的一种新的且具有成本效益的分流工具。
