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目的:探讨检测宫颈不典型鳞状细胞(ASCUS)涂片中P16INK4A的表达对宫颈高度病变的预测价值。方法:采用免疫细胞化学法检测P16INK4A在126例宫颈不典型鳞状细胞涂片中的表达,并与病理学及HPV分型检测结果进行比较。结果:126例ASCUS病理结果为:宫颈炎69例(54.8%);CINⅠ34例(27.0%);CINⅡ16例(12.7%);CINⅢ7例(5.6%)。126例ASCUS患者中P16在CINⅡ~Ⅲ组、宫颈炎与CINⅠ组的阳性率分别为82.6%、24.3%,差异有统计学意义(P<0.01);HPV在CINⅡ~Ⅲ组、宫颈炎与CINⅠ组的阳性率分别为78.3%、40.8%,差异有统计学意义(P<0.01)。126例ASCUS患者中,60例HPV检测阳性,66例阴性,P16在前者的阳性率为36.3%,在后者的阳性率为30.3%,差异无统计学意义(P>0.05)。126例ASCUS患者中,P16、HPV诊断CINⅡ~Ⅲ病变的敏感性分别为:82.6%、78.3%,差异无统计学意义(P>0.05);诊断CINⅡ~Ⅲ的特异性分别为75.7%、59.2%,差异有统计学意义(P<0.05)。结论:P16INK4A的表达与宫颈病变的发生、发展相关,与HPV感染无关。检测P16INK4A有利于鉴别出ASCUS中宫颈高度病变。
Objective: To investigate the predictive value of detecting the expression of P16INK4A in cervical atypical squamous cell carcinoma (ASCUS) smears. Methods: Immunocytochemistry was used to detect the expression of P16INK4A in 126 cases of cervical atypical squamous cell smears, and compared with pathology and HPV typing test results. Results: The pathological findings of 126 cases of ASCUS were: cervicitis in 69 cases (54.8%), CINⅠ in 34 cases (27.0%), CINⅡ in 16 cases (12.7%) and CINⅢ in 7 cases (5.6%). The positive rates of P16 in CINⅡ ~ Ⅲ group, cervicitis and CINⅠgroup in 126 ASCUS patients were 82.6% and 24.3%, respectively, with significant difference (P <0.01). The positive rates of HPV in CINⅡ ~ Ⅲ group, cervicitis and CINⅠ The positive rates were 78.3% and 40.8% respectively, the difference was statistically significant (P <0.01). Of the 126 ASCUS patients, 60 were HPV positive and 66 were negative. The positive rate of P16 in the former was 36.3% and the latter was 30.3%, with no significant difference (P> 0.05). Among 126 ASCUS patients, the sensitivity of P16 and HPV in diagnosing CINⅡ-Ⅲ lesions were 82.6% and 78.3%, respectively, with no significant difference (P> 0.05). The specificity of diagnosis of CINⅡ-Ⅲ was 75.7% and 59.2 %, The difference was statistically significant (P <0.05). Conclusion: The expression of P16INK4A is associated with the occurrence and development of cervical lesions and has nothing to do with HPV infection. Detection of P16INK4A facilitates the identification of cervical lesions in ASCUS.