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目的:探讨液基薄层细胞学检测(TCT)剩余细胞学标本进行p16和Ki-67的免疫细胞化学染色,作为宫颈细胞学检查未明确诊断意义的不典型鳞状上皮细胞(ASCUS)中的分流管理的应用价值。方法:对2008年11月至2009年7月在佛山市妇幼保健院就诊的98例细胞学检查结果为ASCUS的患者进行p16、Ki-67免疫细胞化学染色检测,并与阴道镜下病理活检结果比较。结果:p16、Ki-67表达阳性率随着宫颈病变程度的加重而升高,与病变级别呈正相关。p16在高级别鳞状上皮病变(HSIL)组和低级别鳞状上皮病变(LSIL)组中的阳性表达率与炎症组间比较,差异有统计学意义(P<0.05)。Ki-67在HSIL组中的阳性表达率与LSIL组和炎症组比较,差异有统计学意义(P<0.05)。p16和Ki-67的免疫细胞化学染色检出HSIL及鳞状细胞癌(SCC)的敏感度为83.3%(20/24)和91.7%(22/24);特异度为80.4%(74/92)和86.0%(74/86)。结论:利用TCT剩余细胞学标本进行p16和Ki-67的免疫细胞化学染色,是一种有效、简便的ASCUS分流管理的生物学标记物,可提高HSIL的检出率,使高危患者得到及时有效的治疗。
OBJECTIVE: To investigate the immunocytochemical staining of p16 and Ki-67 in remaining cytology specimens of liquid-based thin-layer cytology (TCT) in cervical squamous cell carcinoma (ASCUS) with undetermined diagnostic significance Application value of diversion management. Methods: A total of 98 patients with ASCUS who underwent cytological examination in Foshan MCH from November 2008 to July 2009 were examined by immunocytochemistry with p16 and Ki-67. The results of colposcopy and colposcopic biopsy Compare Results: The positive rates of p16 and Ki-67 increased with the severity of cervical lesions, and positively correlated with the grade of lesions. The positive expression rate of p16 in high-grade squamous cell carcinoma (HSIL) group and low-grade squamous cell carcinoma (LSIL) group were significantly different from those in inflammation group (P <0.05). The positive expression rates of Ki-67 in HSIL group were significantly different from those in LSIL group and inflammatory group (P <0.05). The sensitivity of immunohistochemical staining of p16 and Ki-67 was 83.3% (20/24) and 91.7% (22/24) respectively for HSIL and SCC; the specificity was 80.4% (74/92 ) And 86.0% (74/86). CONCLUSIONS: Immunocytochemical staining of p16 and Ki-67 using the remaining cytological specimens of TCT is an effective and simple biological marker for ASCUS shunt management, which increases the detection rate of HSIL and makes timely and effective use of high-risk patients Treatment.