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首页> 外文期刊>Acta Cytologica: The Journal of Clinical Cytology and Cytopathology >P16(INK4a) immunocytochemistry in liquid-based cytology samples in equivocal Pap smears: added value in management of women with equivocal Pap smear.
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P16(INK4a) immunocytochemistry in liquid-based cytology samples in equivocal Pap smears: added value in management of women with equivocal Pap smear.

机译：P16（INK4a）免疫细胞化学在含糊巴氏涂片液中的液体细胞学样本中的应用：在治疗含糊巴氏涂片妇女中增加了价值。

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OBJECTIVE: To test whether p1l6(INK4a) immunocytochemistry (ICC) in liquid-based cytology (LBC) is useful with colposcopy in abnormal Pap smears. STUDY DESIGN: A series of 248 women with abnormal Pap smear were analyzed for oncogenic (HR) human papillomavirus (HPV) types using the Hybrid Capture II assay and for p16(INK4a) expression using ICC on cervical samples in PreservCyt liquid media. Colposcopic and loop electrosurgical excision procedure (LEEP) cone biopsy were the gold standard. RESULTS: p16(INK4a) ICC did best as predictor of high-grade squamous intraepithelial lesion, with OR 12.18 (2.72-54.57) (p = 0.0001), showing 88.2% sensitivity (SE), 61.9% specificity (SP), 14.6% positive predictive value (PPV) and 98.6% negative predictive value (NPV). In sorting discrepant cases, p16(INK4a) ICC results in 100% SE and 100% NPV in detecting cervical intraepithelial neoplasia (CIN) 2 lesions among Pap+/biopsy- women. In atypical squamous cells undetermined significance (ASCUS) cytology, adding p16(INK4a) ICC improves specificity of colposcopy from 27.3% to 81.8% and PPV from 42.8% to 71.4%. Best performance is obtained with p16(INK4a) ICC and colposcopy: 83.3% SE, 81.8% SP, 71.4% PPV and 90.0% NPV. CONCLUSION p16(INK4a) is useful in sorting clinically relevant discrepant cases, and p16(INK4a) ICC significantly improves SP and PPV of colposcopy in management of ASCUS cytology.
机译：目的：检测液基细胞学（LBC）中的p16（INK4a）免疫细胞化学（ICC）是否可用于阴道镜检查以进行异常的子宫颈抹片检查。研究设计：使用Hybrid Capture II分析了一系列248例巴氏涂片异常的妇女的致癌（HR）人乳头瘤病毒（HPV）类型，并使用ICC在PreservCyt液体培养基中的宫颈样本上分析了p16（INK4a）的表达。阴道镜和环形电外科切除术（LEEP）锥切活检是金标准。结果：p16（INK4a）ICC最好地预测了高度鳞状上皮内病变，OR为12.18（2.72-54.57）（p = 0.0001），显示出88.2％的敏感性（SE），61.9％的特异性（SP），14.6％阳性预测值（PPV）和98.6％阴性预测值（NPV）。在分类差异病例中，p16（INK4a）ICC在检测Pap + /活检妇女中的宫颈上皮内瘤样变（CIN）2病变中导致100％SE和100％NPV。在不确定的非典型鳞状细胞（ASCUS）细胞学中，添加p16（INK4a）ICC可将阴道镜检查的特异性从27.3％提高到81.8％，并将PPV从42.8％提高到71.4％。使用p16（INK4a）ICC和阴道镜检查可获得最佳性能：SE为83.3％，SP为81.8％，PPV为71.4％和NPV为90.0％。结论p16（INK4a）可用于对临床上相关的差异病例进行分类，p16（INK4a）ICC可显着改善阴道镜在ASCUS细胞学处理中的SP和PPV。

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