宫颈液基薄层脱落细胞联合HPV及p16检测在宫颈癌早期筛查中的临床意义

目的：探讨薄层液基脱落细胞检查（TCT）、高危型乳头状瘤病毒（HPV）DNA检测及脱落细胞p16蛋白免疫细胞化学检测在宫颈癌早期筛查中的应用价值。方法对TCT、HC2- HPV- DNA检测至少一项异常的815例患者，利用剩余细胞学标本进行p16免疫组化检测，同时行阴道镜及病理组织学检查进行对照。结果 HC2- HPV- DNA的阳性率和宫颈脱落细胞中p16表达阳性率随着宫颈病变严重程度的增加而明显升高（P＜0.01）。HC2- HPV- DNA＋TCT检测提高了宫颈癌及癌前病变的检出率，p16免疫细胞化学检查则提高了检测的特异度。结论在TCT和HC2- HPV- DNA检测的基础上，联合应用脱落细胞p16免疫细胞化学染色，可提高宫颈癌早期筛查的准确性。

Thin cytology test and HPV DNA detection combined with p16 immunocytochemistry in screening of early cervical cancer

Objective To evaluate the application of thin cytology test（TCT） and Hybrid Capture 2- high risk HPV- DNA test （HC2- HPV- DNA） combined with p16 immunocytochemical staining in screening of early cervical cancer. Methods Total 815 women underwent TCT and HC2- HPV- DNA testing, the specimens with at least one abnormal finding were subject to p16 im-munocytochemical examination, and biopsy under colposcopy was also performed for these patients. Results The positive rate of both HC2- HPV- DNA test and p16 expression increased with the degree of cervical lesions（P〈0.01）. Simultaneous detection of TCT and HC2- HPV- DNA increased the detection rate of cervical cancers and cancer precursor lesions. Incorporation of these two tests with p16 Immunocytochemical staining improved the specificity of detection. Conclusion TCT and HC2- HPV- DNA detec-tion combined with immunocytochemical staining for p16 can improve the specificity of cervical cancer screening.