摘要
目的:探究p16/Ki-67双染、高危型人乳头瘤病毒(HR-HPV)联合鳞状细胞癌相关抗原(SCC-Ag)检测对宫颈高级别鳞状上皮内瘤变(HSIL)的诊断效能。方法:回顾性收集2023年3月-2024年3月本院就诊的210例宫颈病变患者临床资料,均行p16/Ki-67双染、HR-HPV、阴道镜下宫颈活检及血清SCC-Ag检测。以组织病理学诊断为“金标准”,对比p16/Ki-67双染、HR-HPV、血清SCC-Ag单一及其联合检测对高级别HSIL的诊断灵敏度、特异度等;受试者工作特征(ROC)曲线分析不同检测方法对高级别HSIL的诊断效能。结果:宫颈鳞状细胞癌(SCC)、HSIL患者HR-HPV阳性率、p16/Ki-67双染阳性率及血清SCC-Ag阳性率均高于慢性宫颈炎患者,HSIL患者的p16/Ki-67双染阳性率及血清SCC-Ag阳性率均高于低级别鳞状上皮内病变(LSIL)(均P<0.05)。HR-HPV诊断高级别HSIL的灵敏度94.6%、特异度34.6%、准确率55.7%,p16/Ki-67双染诊断高级别HSIL的灵敏度89.2%、特异度84.6%、准确率86.2%,血清SCC-Ag诊断高级别HSIL的灵敏度73.0%、特异度80.2%、准确率77.6%;HR-HPV联合p16/Ki-67双染诊断高级别HSIL的灵敏度86.5%、特异度89.7%、准确率88.6%,3项联合诊断高级别HSIL的灵敏度68.9%、特异度100.0%、准确率89.1%。2项或3项联合诊断的曲线下面积均大于单一HR-HPV检查(均P<0.05)。结论:p16/Ki-67双染、HR-HPV、SCC-Ag联合检测对高级别HSIL的诊断效能较大,诊断特异度及准确率最高。
Objective:To explore the diagnostic efficacy of pl6/Ki-67 double staining,the high-risk human papillomavirus(HR-HPV)combined with the squamous cell carcinoma associated antigen(SCC-Ag)test for the cervical high-grade squamous intraepithelial lesion(HSIL)of patients.Methods:The clinical data of 210 patients with cervical lesions in the hospital from March 2023 to March 2024 were selected in this study retrospectively.All of these patients were performed p16/Ki-67 double staining,HR-HPV test,the colposcopic cervical biopsy and the scrum SCC-Ag level detection.The histopathologic diagnosis of the patients as the"gold standard",the diagnostic sensitivity and specificity of the patients were compared among the pl6/Ki-67 double staining,the HR-HPV test,the scrum SCC-Ag level,and the scrum SCC-Ag level combined with the detection of HSIL.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of the pl6/Ki-67 double staining,the HR-HPV test,the scrum SCC-Ag level,and the scrum SCC-Ag level combined with the detection of HSIL for the HSIL of the patients.Results:The positive rates of the HR-HPV,the pl6/Ki-67 dual staining and the scrum SCC-Ag of the patients with cervical squamous cell carti-noma(SCC)or with HSIL were significantly higher than those of the patients with chronic cervicitis.The positive rates of the pl6/Ki-67 dual staining and the scrum SCC-Ag of the patients with HSIL were significantly higher than those of the patients with low grade squamous intraepithelial lesion(LSIL)(all P<0.05).The sensitivity,the spedficity and the accuracy of HR-HPV of the patients for diagnosing their HSIL were 94.6%,34.6%and 55.7%,respectively,which of the p 16/Ki-67 dual staining of the patients for diagnosing their HSIL were 89.2%,84.6%and 86.2%,respectively,which of the scrum SCC-Ag of the patients for diagnosing their HSIL were 73.0%,80.2%and 77.6%,respectively,which of the HR-HPV combined with the pl6/Ki-67 dual staining of the patients for diagnosing their HSIL were 86.5%,89.7%and 88.6%,respectively,and which of the HR-HPV combined with the pl6./Ki-67 dual staining and the scrum SCC-Ag of the patients for diagnosing their HSIL were 68.9%,100.0%and 89.1%,respective-ly.The area under the curve of the combined HR-HPV and pl6/Ki-67 dual staining,the combined the HR-HPV and the scrum SCC-Ag,the combined pl6/Ki-67 dual staining and scrum SCC-Ag,or the combined HR-HPV,p16/Ki-67 dual staining and scrum SCC-Ag was significantly higher than that of HR-HPV,p16/Ki-67 dual staining or scrum SCC-Ag alone(all P<0.05).Conclusion:The combined pl6/Ki-67 double staining,HR-HPV and SCC-Ag detection for the HSIL of the patients has higher diagnostic efficacy,and which has the highest diagnostic specificity and accuracy for HSIL of the patients.
作者
张玉平
宣婉丽
ZHANG Yuping;XUAN Wanli(Northwest Women's and Children's Hospital,Xi'an,Shanxi Province,710061;The Third Affiliated Hospital of Xi'an Medical University,Xi'an)
出处
《中国计划生育学杂志》
2025年第7期1640-1645,共6页
Chinese Journal of Family Planning
关键词
宫颈病变
高级别鳞状上皮内瘤变
p16/Ki-67双染
高危型人乳头瘤病毒
鳞状细胞癌相关抗原
诊断效能
Cervical lesions
High-grade squamous intraepithelial lesion
Double staining of pl6/Ki-67
High-risk hu-man papillomavirus
Squamous cell carcinoma associated antigen
Diagnostic efficacy
