常规细胞学与DNA定量分析联合诊断在宫颈CIN Ⅲ及以上级别病变中的应用  

Application of conventional cytology combined with DNA quantitative cytology in diagnosis of CIN Ⅲ/CIS and cervical carcinoma

作　　者：韩永良[1] 涂露霞[2] 王洁[1] 

机构地区：[1]九江市第一人民医院病理科,江西九江332000 [2]南昌大学第一附属医院病理科,湖南南昌330006

出　　处：《诊断病理学杂志》2015年第10期631-633,650,共4页Chinese Journal of Diagnostic Pathology

基　　金：卫生部医药卫生科技发展研究项目(W2011GI03)

摘　　要：目的探讨宫颈常规细胞学和DNA定量分析方法联合诊断在宫颈CIN Ⅲ及以上级别宫颈病变中的应用价值。方法对我院宫颈防癌普查的8448名妇女分别行常规细胞学及细胞DNA倍体分析,并做出联合诊断建议。结果以活检结果为诊断金标准,在1041例活检病例中,计算出常规细胞学ASC-H以上者105例,在CIN Ⅲ及以上级别宫颈病变中敏感性为39%,特异性为94.4%,细胞DNA倍体分析中异常倍体细胞≥3个共253例,在CIN Ⅲ及以上级别宫颈病变中敏感性为74.5%,特异性为83.6%,而常规细胞学与DNA定量分析联合诊断阳性结果为308例,敏感性为80.9%,特异性为78.4%。结论常规细胞学与DNA定量分析方法的联合检测可提高CIN Ⅲ及以上级别宫颈病变中的检出率,减少漏诊,有利于宫颈病变的早期诊断及早期治疗。Objective To study the application of conventional cytology combined with DNA quantitative cytology in diagnosis of CIN Ⅲ / CIS and cervical carcinoma. Methods The DNA quantitative cytology and conventional cytology were analyzed in the screening of cervical lesions for 8448 women. Results The final diagnosis was established on pathological study which is the ＂gold standard＂. All cases of ASC-H,LSIL,HSIL by conventional cytology were 105 in total 1041 cases. The sensitivity of 39. 0% at specificity of 94. 4% were calculated for conventional cytology. All cases of abnormal somatic cells greater than or equal to 3 by DNA quantitative cytology were 253 cases,The sensitivity of 74. 5% at specificity of 83. 6% were calculated for DNA quantitative cytology. Meanwhile,All cases of conventional cytology combined with DNA quantitative cytology were 308. The sensitivity of 80. 9% at specificity of 78. 4% were calculated.Conclusion The screening for CINⅢ / CIS and cervical cancer by conventional cytology combined with DNA quantitative cytology could be higher sensitivity,and reduce the misdiagnosis. It is very helpful to the diagnosis and treatment earlier.

关 键 词：常规细胞学 DNA定量分析 CIN Ⅲ及以上级别宫颈病变 病理学检查 

分 类 号：R446.8[医药卫生—诊断学] R737.33[医药卫生—临床医学]