Abstract:Objective To apply detection of p16INK4a protein in cervical exfoliated cells by time-resolved fluoroimmunoassay (TRFIA) to screening cervical neoplasm. Methods We collected the specimens with cervical biopsy, thinprep cytologic test (TCT) and/or DNA ploidy analysis in Department of Pathology, the First People’s Hospital of Jingmen City from January, 2015 to May, 2016. The cervical exfoliated cells were centrifuged and dropped on the films for TCT. DNA ploidy analysis was performed after Feulgen staining, and TRFIA was used to detect p16INK4a protein. Results Among 694 specimens diagnosed by histopathology, there were 501 cases with cervicitis and 193 with cervical neoplasia (including 83 cases with low grade squamous intraepithelial lesion (LSIL), 89 with high grade squamous intraepithelial lesion (HSIL) and 21 with squamous cell carcinoma (SCC). The sensitivity and specificity of TCT for screening of cervical neoplasm were 76.68% and 87.03%. The sensitivity(84.97%) of DNA ploidy was superior to that of TCT(χ2=4.280,P=0.039) , while the specificity(73.45%) was inferior(χ2=29.105,P<0.0001). The sensitivity of p16INK4a detection via TRFIA was 86.01%, similar to that of DNA ploidy analysis (χ2=0.084, P=0.773) but superior to that of TCT (χ2=5.532, P=0.019), and the specificity was 92.42% , superior to that of TCT (χ2=7.889, P=0.005). Conclusions Detection of p16INK4a protein in cervical exfoliated cells by TRFIA displays a high sensitivity and specificity for screening cervical neoplasm . In addition, it has the advantages of simple operation, low cost, automatic detection and providing objective judgment results if the kit reaches commercialization level.
丁莉, 陈琼, 邹先进, 郑杰. 时间分辨荧光法检测宫颈脱落细胞p16INK4a蛋白用于宫颈肿瘤筛查[J]. 实用预防医学, 2018, 25(1): 30-33.
DING Li, CHEN Qiong, ZOU Xian-jin, ZHENG Jie. Application of detection of p16INK4a protein in cervical exfoliated cells by time-resolved fluoroimmunoassay to screening of cervical neoplasm. , 2018, 25(1): 30-33.
[1] Shidham VB, Mehrotra R, Varsegi G, et al. P16 immunocytochemistry on cell blocks as an adjunct to cervical cytology: potential reflex testing on specially prepared cell blocks from residual liquid-based cytology specimens[J]. Cyto J, 2011,8(1):1. [2] Schmidt D, Bergeron C, Denton KJ, et al. p16 /ki-67 dual-stain cytology in the triage of ASCUS and LSIL papanicolaou cytology results from the european equivocal or mildly abnormal papanicolaou cytology study[J]. Cancer Cytopathol, 2011,119(3):158-166. [3] Yu LL, Chen W, Lei XQ, et al. Evaluation of p16/Ki-67 dual staining in detection of cervical precancer and cancers: a multicenter study in China[J]. Oncotarget, 2016,7(16):21181-21189. [4] Bountris P, Haritou M, Pouliakis A,et al. An intelligent clinical decision support system for patient-specific predictions to improve cervical intraepithelial neoplasia detection[J]. Biomed Res Int, 2014,2014:341483. [5] Kava S, Rajaram S, Arora VK,et al. Conventional cytology, visual tests and evaluation of p16INK4a as a biomarker in cervical intraepithelial neoplasia[J]. Indian J Cancer, 2015,52(3):270-275. [6] 孙小蓉,汪键,Alfred Boecking.DNA倍体分析系统用于宫颈癌及上皮内瘤变的诊断及检测[J].中华病理学杂志,2005,4(7):435-437. [7] 阳艳,段洁,黄燕明,等.DNA倍体分析和液基细胞学在宫颈病变早期筛查中的应用[J].实用预防医学,2016,23(4):444-446. [8] Yu LL, Chen W, Lei XQ, et al. Evaluation of p16/Ki-67 dual staining in detection of cervical precancer and cancers: a multicenter study in China[J]. Oncotarget, 2016,7(16):21181-21189. [9] 刘彬,吴泽妮,刘潇阳,等.人乳头瘤病毒与子宫颈腺癌病因关系研究[J].中华肿瘤杂志,2016,38(4):277-282. [10] Bibbo M, DeCecco J, Kovatich AJ. p16INK4a as an adjunct test in liquid-based cytology[J]. Anal Quant Cytol Histol, 2003,25(1):8-11. [11] Hoshikawa S, Sano T, Yoshida T, et al.Immunohistological analysis of HPV L1 capsid protein and p16 protein in low-grade dysplastic lesions of the uterine cervix[J]. Pathol Res Pract, 2010,206(12):816-820. [12] Volgareva G,Zavalishina L,Andreeva Y,et al. Protein p16 as a marker of dysplastic and neoplastic alterations in cervical epithelial cells[J]. Cancer, 2004,4(1):58.