未明确诊断意义的不典型子宫颈鳞状细胞伴DNA倍体异常的临床意义  

The clinical significance of ASCUS cases with abnormal DNA ploidy

作　　者：孔丽华 李春东[2] 吕佳慧[2] 任东平[2] 孙小蓉 

机构地区：[1]湖北省宜昌市夷陵区妇幼保健院,443100 [2]中国人民解放军空军总医院妇产科 [3]湖北省中山医院细胞病理室

出　　处：《中国妇产科临床杂志》2012年第4期271-273,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：湖北省研究与开发计划项目(2009BCB023)

摘　　要：目的通过宫颈细胞学和DNA倍体分析,探讨未明确诊断意义的不典型鳞状细胞(ASCUS)伴有DNA倍体异常的临床意义。方法选择2010年7月至2011年7月湖北省宜昌市妇幼保健院在夷陵地区进行宫颈癌筛查的635例农村妇女的宫颈细胞学、病理学及DNA倍体分析资料进行分析。将宫颈脱落细胞制成两张玻片,一张巴氏染色行TBS诊断,另一张Feulgen染色行DNA倍体分析。结果在635例宫颈细胞学标本中,正常细胞学418例,ASCUS 145例,不除外高度鳞状上皮内病变(ASC-H)17例,低度鳞状上皮内病变29例,高度鳞状上皮病变26例,其中伴DNA倍体异常(非整倍体细胞)者所占比例分别为2.6%(11/418)、22.8%(33/145)、76.5%(13/17)、89.7%(26/29)和96.2%(25/26)。在阴道镜下活检的145例ASCUS患者中,伴DNA倍体异常者33例,其中10例(30.3%)为CIN2及以上病变;DNA倍体正常者112例,其中9例(8.0%)为CIN2;两者比较,差异有统计学意义(P<0.01)。17例ASC-H患者中,13例(76.5%)DNA倍体异常者均检出CIN2及以上病变;4例DNA倍体正常者检出1例CIN2,两者比较,差异有统计学意义(P<0.01)。结论 ASCUS、ASC-H伴有DNA倍体异常患者检出CIN2及以上病变风险增高。Objective To investigate the significance of ASCUS cases with DNA aneuploidy.Methods 635 women were underwent cervical cancer screening from July,2010to July,2011.For each woman two slides were made by a cytospin.One slide was stained by Pap solution for TBS diagnosis,the other one was stained by Feulgen for DNA ploidy analysis.635cases with abnormal finding underwent cervical biopsies.Results 145ASCUS,17 ASC-H,29LSIL and 26HSIL were found by TBS diagnosis.More than 5caneuploid cells were determined in 22.8%of ASCUS,76.5%of ASC-H,89.7% of LSIL and 96.2% of HSIL cases.84cases of CIN2,CIN3or cancers were found in 635cervical biopsies.30.3% ASCUS and 76.5% ASC-H with aneuploid cells were comfirmed as CIN2,CIN3or cancer,while 8.0% ASCUS and 25.0% ASC-H with diploid cells were diagnosed as CIN2,CIN3 or cancer.Conclusion ASCUS and ASC-H with aneuploid cells has high risk for CIN2,CIN3or cancers.

关 键 词：DNA倍体 图像分析 宫颈癌 未明确诊断意义的不典型鳞状细胞 

分 类 号：R737.33[医药卫生—肿瘤]