p16INK4a在宫颈液基细胞学辅助筛查中的标记意义

目的 评价p16INK4a在宫颈液基细胞学检查中的标记意义.方法 收集74例宫颈外口和颈管的脱落细胞标本,分别进行液基细胞学检测和p16INK4a免疫细胞化学染色,并应用杂交捕获二代法检测高危人乳头瘤病毒(HR-HPV)感染.结果 74例标本中,细胞学诊断未见癌细胞或癌前病变细胞(阴性)10例,意义不明的不典型鳞状细胞(ASC-US)15例,鳞状上皮内低度病变(LSIL)28例,不除外上皮内高度病变的不典型鳞状细胞(ASC-H)5例,鳞状上皮内高度病变(HSIL)11例,鳞状细胞癌(SCC)5例.各级别病变中,HR-HPV阳性者分别为1、4、3、9、7和5例,p16INK4a免疫细胞化学染色阳性者分别为2、5、3、8、9和5例.随着宫颈病变级别的上升,HR-HPV和p16INK4a免疫细胞化学染色阳性率均增高.结论 p16INK4a免疫细胞化学染色增强了对不典型细胞的区分能力,可以提高宫颈癌筛查的准确性.

Role of p16INK4a as a biomarker in liquid-based cervical cytology screening

OBJECTIVE: In cervical lesions, the overexpression of p16INK4a has been reported to be closely associated with human papillomavirus (HPV) infection. This study is designed to evaluate the role of p16INK4a as a biomarker in liquid-based cervical cytology screening. METHODS: Seventy-four specimens from the patients in our hospital were collected for this study. After cytological examination with liquid-based cervical smears, high-risk HPV (HR-HPV) DNA was then detected by Hybrid Capture II assay, and the rest cells were immunostained for p16INK4a. RESULTS: Of the 74 specimens, 10 were diagnosed as negative, 15 as atypical squmous cells of undetermined significance (ASC-US), 28 as low-grade squamous intraepithelial lesion (LSIL), 5 as atypical squmous cells which could not be excluded as HSIL (ASC-H), 11 high-grade squamous intraepithelial lesion (HSIL) and 5 as squamous cell carcinoma (SCC). The positive specimens of p16INK4a were 2, 5, 8, 3, 9, 5, respectively, in the above subgroups; meanwhile, the positive specimens of HR-HPV were 1, 4, 9, 3, 7, 5, respectively, in the above groups. The positive rate of both p16INK4a and HR-HPV in HSIL, ASC-H and SCC were obviously higher than that in LSIL, ASC-US and negative cases. CONCLUSION: Positive rate of p16INK4a and HR-HPV is highly correlated with the grade of the cervical lesion. p16INK4a immunocytochemical staining may be used as a biomarker to increase the sensitivity of cervical cytology screening and the specificity of HPV test.