液基薄层细胞学联合DNA定量方法对宫颈病变诊断试验的评价  

A evaluation on cervical intraepithelial lesion and cervical cancer screening by DNA quantitative analysis and liquid-based monolayer cytology

作　　者：侯安丽[1] 张玉娟[1] 李秀芬[1] 邵雪斋[1] 王杏茶[1] 

机构地区：[1]承德医学院附属医院妇科,河北承德067000

出　　处：《中国实验诊断学》2012年第4期653-655,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的评价采用液基薄层细胞学联合DNA定量分析方法进行宫颈癌普查的工作效率。方法对参与宫颈癌普查的2 599名妇女用宫颈刷取材,进行液基薄层制片,分别进行巴氏染色和Feulgen染色,由细胞学医师对巴氏染色片做细胞学诊断,应用全自动DNA定量分析对Feulgen染色片进行自动扫描诊断。其中156例进一步做了宫颈组织病理诊断。结果 DNA定量分析方法的敏感度、特异度、准确度、阳性预测值、阴性预测值、阳性似然比均高于液基薄层细胞学方法,而误诊率、漏诊率及阴性似然比均低于液基薄层细胞学方法。液基薄层细胞学和DNA定量分析方法的平行诊断试验的联合敏感度和联合特异度分别是99.56%、44.52%,两种方法的系列诊断试验的联合敏感度和联合特异度分别是83.78%、89.61%。平行诊断试验的敏感度最高,系列诊断试验的特异度最高。结论 DNA定量分析方法与液基薄层细胞学联合筛查,可提高宫颈癌前病变及宫颈癌筛查的敏感度和特异度。Objective To evaluate the working efficiency of cervical cancer screening by combining DNA quantitative analysis with liquid-based monolayer cytology.Methods A total of 2599 women were involved in this study and cervical samples were taken by a cervical brush.Monolayer of cells were deposited onto microscopic slides by liquid-based sampling preparation.Two slides were prepared from each case： one slide was stained by Papanicolaou stain for conventional cytology examination,while the other slide was stained by Feulgen method for determination of amount of DNA using an automated DNA imaging cytometry.156 women of the total were followed by pathological examination of cervical tissue.Results The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and positive likelihood ratio of DNA quantitative analysis are higher than liquid-based monolayer cytology,however the mistake diagnostic rate,omission diagnostic rate and negative likelihood ratio are lower than liquid-based monolayer cytology.The combining sensitivity and the combining specificity of parallel tests between DNA quantitative analysis and liquid-based monolayer cytology were 99.56%、44.52%,respectively.The combining sensitivity and the combining specificity of serial tests between the two methods were 83.78%、89.61%,respectively.The sensitivity of parallel tests is the highest,The specificity of serial tests is the highest.Conclusion Liquid-based monolayer cytology combined with quantitative DNA analysis may increase the sensitivity and specificity of cervical precancerous lesions and early cervical carcinoma.

关 键 词：宫颈上皮内瘤样变 DNA定量分析 液基薄层细胞学 宫颈癌前病变 

分 类 号：R737.33[医药卫生—肿瘤]