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p16/Ki67 dual staining improves the detection specificity of high‐grade cervical lesions
Author(s) -
Zhang Ruiyi,
Ge Xuefei,
You Ke,
Guo Yanli,
Guo Hongyan,
Wang Yanjie,
Geng Li
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13760
Subject(s) - medicine , staining , cytology , squamous intraepithelial lesion , cervical intraepithelial neoplasia , human papillomavirus , pathology , gastroenterology , cervical cancer , gynecology , cancer
Aim The goal of this study was to analyze the specificity of p16/Ki67 dual staining in the detection of high‐grade cervical lesions. Methods A total of 223 patients with an average age of 39 years old were enrolled in this study. All samples were analyzed by p16/Ki67 immunocytochemical dual staining, liquid‐based cytology and high‐risk human papillomavirus (HR‐HPV) test. Diagnosis of each patient was verified by histopathological test. Results The specificity of p16/Ki67 dual staining was 68.33%, which was significantly higher than that of cytology (38.33%) and HR‐HPV test (21.67%) ( P < 0.05) for CIN2+ detection. p16/Ki67 dual staining had similar sensitivity with HR‐HPV test for CIN2+ detection (90.18% vs 93.87%, P = 0.286). In atypical squamous cells of undetermined significance (ASC‐US) and low‐grade squamous intraepithelial lesion (LSIL) cases, the specificity of p16/Ki67 dual staining was significantly higher than that of HPV test (66.67% vs 3.70%, P < 0.05) and its sensitivity was similar to that of HPV test for CIN2+ detection. The sensitivity and specificity of dual staining for CIN2+ detection in HR‐HPV positive women were 90.85% and 70.21%, respectively, which were higher than those of cytology (83.01% and 42.55%) and HPV16/18 test (70.59% and 44.68%). Conclusions p16/Ki67 dual staining could improve the specificity of high‐grade cervical lesions detection and have similar sensitivity to HPV test for CIN2+ detection. When triaging women with ASC‐US or LSIL liquid‐based cytology, compared with positive HR‐HPV, the specificity of CIN2+ lesion detection was increased by p16/Ki67 dual staining. p16/Ki67 dual staining could reduce colposcopy referrals and avoid excessive diagnosis and treatment.