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目的:探讨p16INK4A和cyclin E在宫颈脱落细胞的阳性表达率及其诊断价值。方法:以病理学诊断为金标准,选取171例细胞学与病理学诊断相吻合的宫颈脱落细胞涂片,采用免疫组化方法分析涂片中p16INK4A和cyclin E表达的敏感性和特异性。其中宫颈鳞状细胞癌(SCC)56例,高度鳞状上皮内病变(HSIL)35例,低度鳞状上皮内病变(LSIL)48例,不典型鳞状细胞(ASC)32例。结果:在56例SCC、35例HSIL、48例LSIL、32例ASC中p16INK4A的阳性表达率分别为100.00%、91.43%、68.75%、21.88%;cyclin E的阳性表达率分别为87.50%、82.86%、83.33%、28.13%。而p16INK4A、cyclin E联合检测时,则阳性表达率均有提高。两种检测方法的敏感性>85%,特异性>70%。结论:p16INK4A和cyclin E共同参与了宫颈病变的发生与发展,可应用于宫颈病变的筛查和诊断,以提高诊断准确率,cyclin E可能是宫颈上皮内瘤变的早期标志物之一。
Objective: To investigate the positive expression rate of p16INK4A and cyclin E in exfoliated cells and its diagnostic value. Methods: According to the gold standard of pathology, 171 cases of cervical exfoliated cell smears which were cytologically and pathologically diagnosed were selected. The sensitivity and specificity of p16INK4A and cyclin E expression in the smears were analyzed by immunohistochemistry. There were 56 cases of SCC, 35 cases of high grade squamous intraepithelial lesion (HSIL), 48 cases of low grade squamous intraepithelial lesion (LSIL) and 32 cases of atypical squamous cell (ASC). Results: The positive rates of p16INK4A in 56 cases of SCC, 35 cases of HSIL, 48 cases of LSIL and 32 cases of ASC were 100.00%, 91.43%, 68.75% and 21.88%, respectively. The positive rates of cyclin E were 87.50% and 82.86 %, 83.33%, 28.13%. The p16INK4A, cyclin E joint detection, the positive expression rate increased. Sensitivity> 85% and specificity> 70% for both assays. Conclusion: p16INK4A and cyclin E are involved in the occurrence and development of cervical lesions. They can be used in screening and diagnosis of cervical lesions to improve the diagnostic accuracy. Cyclin E may be one of the early markers of cervical intraepithelial neoplasia.