The value of p16 INK4a cytology for early diagnosis of cervical cancer
10.3760/cma.j.cn112151-20191203-00779
- VernacularTitle:宫颈癌早期诊断中细胞学p16 INK4a检测的价值
- Author:
Lüfang DUAN
1
;
Hui DU
;
Aimin XIAO
;
Chun WANG
;
Peisha YAN
;
Xia HUANG
;
Ruifang WU
Author Information
1. 北京大学深圳医院妇产科暨深圳女性重大疾病早期诊断技术重点实验室 518036
- Keywords:
Uterine cervical neoplasms;
Cervical intraepithelial neoplasia;
Cyclin-dependent kinase inhibitor p16;
Cytological techniques;
Immunochemistry
- From:
Chinese Journal of Pathology
2020;49(8):812-815
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the use of p16 INK4a immuno-stained cytology as the primary screening for cervical cancer prevention. Methods:From March to August 2018, 902 women from Shenzhen and surrounding area were recruited for cervical cancer screening with ThinPrep Cytologic Test (TCT), cobas4800 HPV test, and p16 INK4a co-test. Colpo/biopsies were performed using the point of interest biopsy protocol of directed and random cervical biopsies plus endocervical curettage for all women, any of whose tests was positive. Two senior cytopathologists interpreted TCT and p16 INK4a test. The performance of p16 INK4a for early detection of CIN2+ and inter-observer reproducibility of the interpretation of p16 INK4a were evaluated. Results:The positive rates of HPV test, p16 INK4a co-test and TCT diagnosed as LSIL/AGC or higher grade were 8.1% (73/902), 6.8% (61/902) and 4.7% (42/902), respectively. Colposcopy referring rate was 79.6% (109/137), among which 10 cases were diagnosed as CIN2+ (5 cases of CIN2 and 5 cases of CIN3). The sensitivity and specificity for CIN2+ of p16 INK4a test, TCT (LSIL/AGC or higher grade) and HPV test were 90.0%, 80.0%, 100.0% and 90.9%, 91.9%, 82.5%, respectively. Compared to TCT and HPV test, there was no significant difference in sensitivity and specificity between p16 INK4a and TCT/HPV test ( P>0.05). The Kappa value of the 2 cytopathologists in interpreting p16 INK4a and TCT was 0.944 and 0.425, respectively ( P<0.05). Conclusions:p16 INK4a for cervical cancer screening is equally sensitive to HPV test and specific to TCT while subjective difference of cytopathologists′ interpretation of p16 INK4a is small. Therefore, p16 INK4a can be used as a new cervical cancer screen method for its better diagnostic performance.
