p16 is an early discovered tumor suppressor gene, which can inhibit the metastasis of various tumors
The product encoded by the p16 gene, the p16 protein, also known as p16'Nk4a, is mainly present
In the nucleus and in the cytoplasm, it is a biomarker of whether cervical cell cycle regulation is affected by HPV infection.
p16: Nucleus, cytoplasm
1. Identification of high-grade squamous epithelial lesions of cervix with metaplasia and atrophy
2. Sensitive markers of differentiated liposarcoma
顶级期刊Cancer(Cancer Cytopathology) 杂志文献指出，在预测潜在高级病变上，p16检测优于HR-HPV检测，两者敏感性相当，p16检测的特异性显著高于HR-HPV检测。而且，病变级别越高，p16越敏感，所以p16高表达强烈提示为HSIL。以组织学CIN2+为终点，p16检测和HR-HPV灵敏度相当，但其特异性优于HR-HPV。
Homer,Petra,Burke, Stephanie, Franquemont,D W, Thompson, Elaine C, Dehn, Donna L & Titmus,Matthew A,etal.(2010).P16(INK4a)is superior to high-risk human papillomavirustesting in cervicalcytology for the prediction ofunderlying high-grade dysplasia. Cancer Cytopathology,118(5),303-303.
医学顶级期刊THE LANCETONCOLOGY (《柳叶刀: 肿瘤学》，IF=35) 文献指出: 相比常规细胞学检查，HPV检查联合p16检测会显著提高敏感性，并且不会显著增加转阴道镜的概率。联合p16检测，避免了HPV检查灵敏度高但特异性差的问题。
Carozzi F, Confortini M ,Palma P D,etal.Use of p16INK4a overexpression to increase thespecificity of human papillomavirus testing: a nested substudy of the NTCC randomisedcontrolled trial[J].2008,9(10):0-945.
综上所述：
1、提高敏感性和特异性；p16 ICC的敏感性与HPV检测相当(>90%)，特异性显著优于HPV检测，具有统计学意义。
2、p16 ICC阳性与否预示着HPV感染是瞬间还是持续性，p16 ICC阳性的细胞提示细胞学医生重审液基学结果。
3、细胞学检测的p16的目的及范围高于组织学。
4、减少工作量，提高阅片效率，降低医疗风险。
