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目的评价P16和P53在宫颈液基细胞学诊断宫颈细胞学不典型鳞状细胞不除外上皮内高度病变(ASC-H)中辅助检测的标记意义。方法对59例ASC-H患者分别进行P16、P53免疫组织化学(IHC)检测、聚合酶链反应(PCR)-反向点杂交法进行人乳头瘤病毒(HPV)分型和阴道镜检查及活检,分析其结果之间的关系。结果 59例ASC-H中,P16、P53阳性者主要为鳞状上皮内高度病变(HSIL)及以上病变,包括28例HSIL和5例活检结果为宫颈鳞状细胞癌(SCC)的病例;随着宫颈病变级别的上升,P16、P53阳性率增高;35例高危型HPV阳性均为HSIL及以上病变,对ASC-H患者HSIL的敏感性及阴性预测值均为100%。结论 ASC-H高度提示高级别的宫颈病变存在;P16、P53的IHC结果与HPV分型检测结果具有良好的一致性,均可提示ASC-H患者应进一步行阴道镜检查及活检;但P16、P53的IHC检测更加方便、快速。
Objective To evaluate the significance of the detection of P16 and P53 in the diagnosis of cervical atypical squamous cell carcinoma (ASC-H) by cervical liquid-based cytology. Methods 59 cases of ASC-H patients were detected by P16, P53 immunohistochemistry (IHC), polymerase chain reaction (PCR) - reverse dot blot hybridization of human papillomavirus (HPV) typing and colposcopy and biopsy , Analyze the relationship between the results. Results Among 59 cases of ASC-H, P16 and P53 positive were mainly from squamous intraepithelial lesion (HSIL) and above, including 28 cases of HSIL and 5 cases of cervical squamous cell carcinoma (SCC) The positive rate of P16 and P53 increased with the increase of cervical lesions. The positive rate of HSIL in 35 cases of high risk HPV was HSIL and above, and the sensitivity and negative predictive value of HSIL in ASC-H were all 100%. Conclusions ASC-H is highly suggestive of high-grade cervical lesions. IHC results of P16 and P53 are in good agreement with HPV genotyping results, which may indicate that colposcopy and biopsy should be further performed in patients with ASC-H. However, P16, IHC detection of P53 more convenient and fast.