DNA定量分析联合高危型HPV检测对高级别CIN的检出价值  

Diagnostic value of DNA quantitative cytology in high- grade cervical intraepithelial neoplasia

作　　者：钟萍萍[1] 王军[1] 王爱春[1] 孙笑非[1] 张晓波[1] 谢俊玲[1] 顾依群[1] 

机构地区：[1]北京市海淀区妇幼保健院病理科,北京100080

出　　处：《现代肿瘤医学》2015年第5期682-685,共4页Journal of Modern Oncology

基　　金：北京市海淀区科技项目(编号:K2008058)

摘　　要：目的:研究宫颈细胞DNA定量分析联合高危型HPV检测在诊断高级别宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的应用价值。方法:收集220例有DNA定量分析、宫颈薄层液基细胞学检查(thinprep cytology test,TCT)、二代杂交捕获(hybrid capture II,HC2)检测高危型人乳头瘤病毒(human papillomavirus,HPV)及宫颈活检资料的病例。结果:以宫颈活检组织病理学为诊断标准,220例活检中60例病理组织学为高级别宫颈上皮内瘤变的病例,DNA定量分析对检测高级别CIN的敏感性为96.7%,特异性为25.0%,阳性预测值为32.6%,阴性预测值为95.2%,而TCT及HC2的敏感性、特异性、阳性预测值及阴性预测值分别为96.7%、3.8%、27.4%、75.0%及98.3%、38.8%、37.6%、98.4%。DNA定量分析除敏感性以外,其他指标均高于TCT检测,而低于HC2检测。DNA定量分析及HC2检测均阴性的病例,阴道镜活检无高级别鳞状上皮内瘤变病例。结论:DNA定量分析在诊断高级别宫颈上皮内瘤变中优于TCT,与HC2检测联用可提高诊断高级别宫颈上皮内瘤变的敏感性和特异性。Objective：To investigate the diagnosis value of DNA quantitative cytology in high - grade cervical in-traepithelial neoplasia（CIN）. Methods：DNA quantitative cytology,hybrid capture II（HC2）to detect high risk human papillomavirus（HPV）,thinprep cytology test（TCT）and cervical biopsy were carried out in 220 cases successively. Results：Histopathology of cervical biopsy acted as diagnosis standard. Among 60 cases of high - grade cervical intra-epithelial neoplasia,58 cases were positive with method of DNA quantitative cytology. The sensitivity,specificity,posi-tive predictive value and negative predictive value of DNA quantitative cytology were 96. 7% ,25. 0% ,32. 6% , 95. 2% respectively,96. 7% ,3. 8% ,27. 4% ,75. 0% of TCT and 98. 3% ,38. 8% ,37. 6% ,98. 4% of HC2. Except the sensitivity,the results of DNA quantitative cytology were higher than TCT,while lower than the results of HC2. None was diagnosed of high - grade cervical intraepithelial neoplasia,which was negative in method of both DNA quantitative cytology and HC2. Conclusion：The method of DNA quantitative cytology is superior to TCT. DNA quanti-tative cytology combined with HC2 can enhance the sensitivity and specificity of diagnosis for high - grade cervical in-traepithelial neoplasia.

关 键 词：DNA 定量分析 宫颈上皮内瘤变 人乳头瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]