DNA倍体分析联合高危型人乳头瘤病毒检测筛查宫颈病变  

Combining DNA Ploidy Analysis and High Risk Type of Human Papillomavirus Detection to Detect Cervical Lesions

作　　者：林丹[1,2] 罗新[1] 蒋学风[1] 王晓玉[1] 易跃雄[2] 赵丽琴[2] 

机构地区：[1]暨南大学附属第一医院,广东广州510630 [2]南方医科大学第三附属医院,广东广州510630

出　　处：《实用妇产科杂志》2014年第7期531-534,共4页Journal of Practical Obstetrics and Gynecology

基　　金：卫生部医药卫生科技发展中心项目(编号:WKJ2007-3-001);广东省产业技术研究与开发资金计划项目(编号:2012B031800398)

摘　　要：目的:探讨DNA倍体分析联合高危型人乳头瘤病毒(HPV)检测对宫颈上皮内瘤变(CIN)Ⅱ级及以上的宫颈病变(CINⅡ+CINⅢ+宫颈癌,以下简称CINⅡ+)的诊断价值。方法:对502例宫颈癌筛查患者同时行宫颈薄层液基细胞学检查(TCT)、细胞DNA倍体分析及高危型HPV检测,对检测异常者进行阴道镜下宫颈活检组织检查,以病理结果为金标准,对比分析TCT、DNA倍体分析、TCT联合高危型HPV检测及DNA倍体分析联合高危型HPV检测对CINⅡ+的诊断价值。结果:TCT对CINⅡ+敏感度为52.17%,特异度为98.24%;DNA倍体分析对CINⅡ+敏感度为78.26%,特异度为90.93%;TCT联合高危型HPV检测对CINⅡ+敏感度为100.00%,特异度为92.70%;DNA倍体分析联合高危型HPV检测对CINⅡ+敏感度为91.30%,特异度为92.19%。结论:DNA倍体分析联合高危型HPV检测是筛查CINⅡ+的有效方法,有一定的临床应用价值,尤其适合在医疗资源缺乏的地区实施。Objective：To evaluate the diagnosis value of DNA image cytometry（DNA-ICM） plus high risk type of HPV detection for cervical intraepithelial neoplasia with grade Ⅱ and higher（CIN Ⅱ ＋ ： CIN Ⅱ ＋ CIN Ⅲ ＋ cervical cancer）. Methods：TCT examination, DNA-ICM and high risk type of HPV detection were per- formed on 502 women who accepted routine cervical cancer screening, and the cervical biopsy was conduc- ted when the abnormal result was found. Pathological results were considered as golden standard ,the results of TCT,DNA-ICM,TCT ＋ high risk type of HPV detection and DNA-ICM ＋ high risk type of HPV detection were compared and analyzed to evaluate their diagnosis value for CIN Ⅱ ＋. Results： With regard to CIN Ⅱ ＋ ,the sensitivity and specificity of TCT was 52.17% and 98.24% respectively;the sensitivity and specific- ity of DNA-ICM was 78.26% and 90. 93% respectively;the sensitivity and specificity of TCT ＋ high risk type of HPV detection was 100. 00% and 92.70% respectively;the sensitivity and specificity of DNA-ICM ＋ high risk type of HPV detection was 91.30% and 92. 19% respectively. Conclusions： DNA-ICM plus high risk type of HPV detection is an effective detection strategy for CIN Ⅱ ＋ screening. This method contains certain clinical practical values and could be induce into practice especially in the area without sufficient medical re- sources.

关 键 词：宫颈病变 筛查 DNA倍体分析 高危型人乳头瘤病毒检测 

分 类 号：R711.74[医药卫生—妇产科学]