液基细胞学联合DNA定量细胞学在筛查宫颈病变中的应用价值  

Value of cervical liquid-based cytology and DNA quantitative cytology in the diagnosis of cervical lesions

作　　者：王琳倩[1] 余辉[1] 高亮 何佩[1] 吴楠[1] 

机构地区：[1]北京军区总医院妇产科,北京100700 [2]厦门麦克奥迪细胞病理诊断中心,福建厦门361006

出　　处：《中国优生与遗传杂志》2014年第5期14-17,80,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨宫颈液基细胞学和DNA定量细胞学在宫颈癌前病变及宫颈癌诊断中的应用价值。方法对2156例患者进行宫颈液基细胞学和DNA定量细胞学检查,对其中221例液基细胞学和(或)DNA定量分析阳性者行宫颈活检,以活检结果为金标准,比较两种方法的检测结果及DNA定量细胞学对ASCUS患者的分流作用。结果 1.液基细胞学以≥ASCUS,DNA定量细胞学以可见DNA倍体异常细胞作为活检标准及联合两种方法检测,活检结果以CINⅠ及以上病理改变作为阳性结果,其敏感度、特异度、阳性预测值、阴性预测值分别为69.77%、77.52%和89.15%,38.04%、48.91%和84.09%,61.22%、63.69%和86.47%,47.30%、60.81%和84.09%。2.TCT与DNA定量细胞学检测方法灵敏度及特异度对比,均无统计学意义(P>0.05);TCT联合应用DNA定量细胞学与单独应用TCT检测方法灵敏度及特异度对比,均有统计学意义(P<0.01);TCT联合应用DNA定量细胞学与单独应用DNA定量细胞学检测方法灵敏度对比,无统计学意义(P>0.05),特异度对比,有统计学意义(P<0.01)。3.ASCUS患者宫颈病变的检出率为56.25%。ASCUS患者以DNA定量细胞学作为分流方法:阳性组检出率为74.00%,阴性组检出率为26.67%,两组检出率对比,有高度统计学差异(P<0.01);DNA定量细胞学阳性组与ASCUS患者未分流前检出率对比,有统计学意义(P<0.05)。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,对于细胞学检测为ASCUS的人群有分流作用。Objective. To investigate the application of cervical liquid-based cytology and DNA quantitative cytology test in the diagnosis of cervical precancerous lesions and early cervical carcinoma. Methods： 2156 patients were detected by cervical liquid-based cytology and DNA quantitative cytology test, and in which of 221 cases with abnormal cervical liquid based cytology and （or） DNA aneuploidy were given cervical biopsy, Analysis clinical significance of two methods for the diagnosis of cervical lesions and the shunting function in patients with ASCUS. Results： 1.The sensitivity, specificity, positive predictive value, negative predictive value of DNA quantitative analysis （DNA ploidy≥ 3） and cervical liquid-based cytology （ASCUS or sever lesions） and combined with two methods in screening CIN I or sever lesions were 69.77%, 77.52% and 89.15%, 38.04%, 48.91%和1184.09%, 61.22%, 63.69% and 86.47%, 47.30%, 60.81% and 84.09%.2. The sensitivity and specificity of TCT in comparison with DNA quantitative analysis detection methods were no statistical significance （P〉0.05） ; The sensitivity and specificity of TCT in comparison with TCT combined with DNA quantitative analysis detection methods were statistical significance （P〈0.01） . The specificity of DNA quantitative analysis in comparison with DNA quantitative analysis combined with TCT quantitative analysis detection methods was no statistical significance （P〉0.05）; the sensitivity was statistical significance （P 〈0.01 ） .3. The detection rate of ASCUS with cervical lesion was 56.25%. DNA quantitative analysis as a shunting method for ASCUS： The detection rate of the positive group was 74.00%, The detection rate of the negative group was 26.67%. A comparison of two groups was statistical significance （P〈0.01） . Contrasting the detection rate of DNA ploidy positive group and ASCUS with no shunting, there was statistical significance （P〈0.05） . Conclusion： DNA quantitative cytology combined with cervical liquid-bas

关 键 词：DNA定量细胞学 液基细胞学 宫颈上皮内瘤变 宫颈癌前病变 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]