P16INK4a及Ki-67免疫细胞化学检测对ASC-US中高级别病变检出的意义

目的：探讨液基细胞学剩余细胞标本P16INK4a、Ki-67免疫细胞化学染色检测宫颈癌前病变的价值。方法：选取2010年1月至2012年6月因宫颈疾病于北京大学第三医院妇产科就诊患者液基细胞学剩余标本50例。所有患者行高危型HPVDNA杂交捕获II代（HCII）检测，P16INK4a、Ki-67免疫细胞化学检测，同时行阴道镜检查及组织病理学活检。结果：以病理诊断将患者分为CIN2以下组和CIN2及以上组。CIN2及以上组P16INK4a及Ki-67表达量高于CIN2以下组，差异均具有统计学意义（P〈0．05）；P16INK4a或Ki-67检测对高级别病变预测的准确性在ASC—US组中优于异常细胞学组；在ASC—US中，P16INK4a或Ki-67检测对高级别病变预测的准确性优于高危型HPV检测。结论：宫颈脱落细胞中P16INK4a或Ki-67免疫细胞化学检测相比于高危型HPV检测可以提高对ASC—US中高级别病变的检出作用。

The Role of P16INK4aand Ki-67 Immunocytochemical Examination to Detect High Level of Lesion in ASC-US

Objective： To investigate the role of P16INK4a and Ki-67 immunocytochemical staining of residual specimens of liquid based cervical cytology in detection of cervical carcinoma and precancerous lesions. Methods： From Jan. 2010 to June 2012, fifty residual specimens of liquid-based cytology were chosen. P16INK4a and Ki-67 immunocyto- chemical staining were detected. HR-HPV DNA test was done by Hybrid Capture II （HCII）. Meanwhile , colposcopy and biopsy were also conducted. Results： The expression level of P16INK4a and Ki-67 was much more higher in the group of ≥ CIN2 than that in 〈 CIN2 group （ P 〈 0.05 ）. The accuracy of P16INK4a and Ki- 67 in ASC-US group was significantly higher than that in abnormal cytology group. In ASC-US group, the accuracy of P16INK4a and Ki-67 was significantly high- er than that of the HR-HPV DNA test in the detection of ≥ CIN2 lesions . Conclusion： P16INK4a or Ki-67 immuncyto- chemical staining of cervical exfoliated cells is helpful in the detection of ≥ CIN2 lesions in abnormal cytology group, espe- cially in ASC-US group.