Very limited information exists about the role of p16/Ki67 dual staining on glandular cells in detecting glandular precancerous lesions and cervical adenocarcinoma. In this study, we investigated the diagnostic accuracy of p16/Ki67 dual staining for the detection of glandular and squamous lesions on the uterine cervix and for cancer of the upper reproductive tract. We performed a retrospective analysis of prospectively collected data on 96 patients with glandular cell abnormalities. We analyzed the diagnostic accuracy of p16/Ki67 dual staining for atypical glandular cells, not otherwise specified (AGC-NOS); atypical glandular cells, favor neoplastic (AGC-FN); adenocarcinoma in situ (AIS); and A-CA (cervical adenocarcinoma). A separate analysis for the detection of squamous precancerous lesions and squamous-cell carcinoma (CIN3+) and for cancer of the upper reproductive tract (EC/OC) was performed. Among patients who had normal histology or a low-grade lesion on final analysis, only 8.5% had positive dual staining. On the other hand, 85.7% of patients with AIS+ on final histology had positive dual staining. The respective specificities of p16/Ki67 dual staining on AGC-NOS for the detection of AIS+ (adenocarcinoma in situ or cervical adenocarcinoma), CIN3+ and EC/OC were 91.5%, 88.7% and 86.4%. High specificity values of p16/Ki67 dual staining on cervical smears labelled as AGC-NOS for the detection of CIN3+ and AIS+ suggest that this method might be a useful addition in cervical cancer screening.
关于p16/Ki67双重染色在腺细胞中对腺体癌前病变和宫颈腺癌检测作用的信息非常有限。本研究探讨了p16/Ki67双重染色在检测宫颈腺体和鳞状上皮病变以及上生殖道癌症中的诊断准确性。我们对前瞻性收集的96例腺细胞异常患者数据进行了回顾性分析，评估了该检测方法对非典型腺细胞（非特指型）、倾向肿瘤的非典型腺细胞、原位腺癌及宫颈腺癌的诊断效能。同时分别分析了该方法对鳞状上皮癌前病变/鳞状细胞癌（CIN3+）及上生殖道癌症（子宫内膜癌/卵巢癌）的检测能力。最终组织学诊断为正常或低级别病变的患者中，仅8.5%呈现双重染色阳性；而最终确诊为原位腺癌及以上病变的患者中，85.7%呈现阳性染色。p16/Ki67双重染色在非特指型非典型腺细胞中对原位腺癌/宫颈腺癌、CIN3+及上生殖道癌症检测的特异性分别为91.5%、88.7%和86.4%。该检测方法在非特指型非典型腺细胞涂片中对CIN3+和原位腺癌及以上病变均表现出高特异性，提示其可能成为宫颈癌筛查的有效辅助手段。
P16/Ki67 Dual Staining in Glandular Cell Abnormalities of the Uterine Cervix
肿瘤(癌症)患者之家