PDF(Pubmed)
Abstract：
Cervical cancer, primarily caused by high-risk human papillomavirus (HR-HPV) types 16 and 18, is a major global health concern. Persistent HR-HPV infection can progress from reversible precancerous lesions to invasive cervical cancer, which is driven by the oncogenic activity of human papillomavirus (HPV) genes, particularly E6 and E7. Traditional screening methods, including cytology and HPV testing, have limited sensitivity and specificity. This review explores the application of p16/Ki-67 dual-staining cytology for cervical cancer screening. This advanced immunocytochemical method allows for simultaneously detecting p16 and Ki-67 proteins within cervical epithelial cells, offering a more specific approach for triaging HPV-positive women. Dual staining and traditional methods are compared, demonstrating their high sensitivity and negative predictive value but low specificity. The increased sensitivity of dual staining results in higher detection rates of CIN2+ lesions, which is crucial for preventing cervical cancer progression. However, its low specificity may lead to increased false-positive results and unnecessary biopsies. The implications of integrating dual staining into contemporary screening strategies, particularly considering the evolving landscape of HPV vaccination and changes in HPV genotype prevalence, are also discussed. New guidelines and further research are necessary to elucidate the long-term effects of integrating dual staining into screening protocols.
摘要：
宫颈癌,主要由高危型人乳头瘤病毒（HR-HPV）16型和18型引起，是全球主要的健康问题。持续的HR-HPV感染可从可逆性癌前病变进展为浸润性宫颈癌,这是由人类乳头瘤病毒（HPV）基因的致癌活性驱动的，尤其是E6和E7。传统的筛选方法,包括细胞学和HPV检测，具有有限的灵敏度和特异性。本文就p16/Ki-67双染色细胞学在宫颈癌筛查中的应用作一综述。这种先进的免疫细胞化学方法允许同时检测宫颈上皮细胞内的p16和Ki-67蛋白，提供了一种更具体的方法来分类HPV阳性女性。比较了双重染色和传统染色方法，显示其高灵敏度和阴性预测值，但特异性低。双重染色的敏感性增加导致CIN2+病变的检出率更高，这对预防宫颈癌进展至关重要。然而,其低特异性可能导致假阳性结果增加和不必要的活检.将双重染色整合到当代筛查策略中的意义，特别是考虑到HPV疫苗接种的变化和HPV基因型流行的变化，也讨论了。需要新的指南和进一步的研究来阐明将双重染色整合到筛选方案中的长期效果。
