ObjectiveTo explore the value of cervical cytological p16INK4a protein assay combined with cytological assay in screening precancerous lesions of uterine cervix and cervical cancer.
MethodsA total of 790 women aged 20 to 70 who volunteered to undergo cervical cancer screening were selected, and the high-risk human papillomavirus(HR-HPV), thinprep cytologic test(TCT) and p16INK4a cytology detection in the subjects were implemented.The colposcopy and biopsy in patients with any positive test result or all negative test results complicated with obvious clinical symptoms with high suspicion of cervical lesions were examined.The detection effects of HPV, TCT and p16 alone, and combined screening for cervical precancerous lesions and cervical cancer were compared.
ResultsAmong all screening subjects, the positive rates of p16, TCT diagnosed as ASCUS or higher grade and HR-HPV were 14.6%, 16.3% and 25.6%, respectively.The positive rates of p16, HPV and TCT gradually increased with the increasing of cervical lesions severity(P < 0.05 to P < 0.01).The sensitivities of p16+TCT, HPV+TCT and p16+HPV detection were 92.1%, 94.7% and 97.4%, respectively.The specificities of p16+TCT, HPV+TCT and p16+HPV detection were 85.6%, 77.5% and 78.8%, respectively.The area under the curve of HPV, TCT, p16, HPV+TCT, p16+HPV, and p16+TCT in the diagnosis of cervical lesions were 0.849, 0.822, 0.893, 0.861, 0.881, 0.889, respectively.The differences of the diagnostic value among each index to cervical lesions were statistically significant(P < 0.01).
ConclusionsCompared with the results of HPV plus TCT, the p16 plus TCT has similar sensitivity and higher specificity for screening cervical precancerous lesions and cervical cance, and can be used as a new screening method for cervical cancer.
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