DNA定量细胞学分析对于HPV阴性的ASCUS的分流作用  

The shunting action of DNA quantitative cytology analysis in HPV-gegative atypical squamous cells of undetermined significance

作　　者：宋文惠[1] 王莉[1] 冯莉[1] 崔文华[1] 于湄[1] 葛军[1] 米冬青[1] 李素辉[1] 

机构地区：[1]河北省石家庄市第四医院产科,050011

出　　处：《河北医药》2016年第14期2105-2108,共4页Hebei Medical Journal

摘　　要：目的探讨DNA定量细胞学分析对于HPV阴性的非典型鳞状上皮细胞（ASCUS）的分流作用。方法对80例HPV阴性的ASCUS患者进行DNA定量细胞学分析,且DNA定量细胞学结果异常者进行阴道镜下宫颈活检。按照DNA指数（DNAindex,DI）将不同DNA定量细胞学结果分为DI〈2.5组（n=41）、DI〉2.5组（n=26）、DI〉5组（n=13）;按照年龄分为3组：≤30岁组（n=28）,31~49岁组（n=30）,≥50岁（n=22）。分析3组DNA定量细胞学结果中CIN检出率及异常DNA定量结果,不同年龄条件下CIN检出率。结果 HPV阴性组中异常DNA倍体细胞的阳性率20%,ASCUS中DNA倍体异常的CIN检出率为38.8%。不同DI组病理结果间比较,差异有统计学意义（P〈0.01）。DI〉5组CIN2及CIN3的检出率均明显高于DI〉2.5组和DI〈2.5组,差异有统计学意义（P〈0.05）。而DI〉2.5组与DI〈2.5组病理结果间比较,差异无统计学意义（P〉0.05）。≥50岁组DNA定量细胞学异常的CIN检出率高于≤30岁组和31~49岁组（63.6%）,其中CIN2及以上病变的检出率为45.5%。不同年龄组组间的DNA定量结果比较差异有统计学意义（P〈0.01）。结论 HPV阴性的ASCUS人群进行DNA倍体分析有助于检出CIN,是分流筛查的有效手段,将DNA定量细胞分析中DI〉5作为宫颈活检的标准可能增加CIN2及以上病变的检出率。Objective To investigate the shunting action of DNA quantitative cytology analysis in HPV-negative atypical squamous cells of undetermined significance（ ASCUS）. Methods A total of 80 patients with HPV-negative ASCUS received DNA ploid analysis of cervical cells,then the abnormal DNA ploid was followed by cervical biopsy under colposcope.According to DNA index（ DI）,the examination results by DNA quantitative cytology analysis were divided into 3 groups： DI 2. 5,DI 2. 5,DI 5,moreover,according to patient＇s age,these patients were also divided into 3 groups： age≤30 years,31 ~49 years,age≥50 years. The abnormal detection rates of CIN and abnormal DNA quantitive examination results were analyzed and compared among the groups. Results The positive rate of abnormal DNA ploid was 20% in HPV-negative group,and the detection rate of CIN of abnormal DNA ploid in patients with ASCUS was 38. 8%. There were significant differences in the pathological examination results among different DI groups（ P 〈0. 01）. The detection rates of CIN2 and CIN3 in DI 5group were significantly higer than those in DI 2. 5 group and DI 2. 5 group（ P 〈0. 05）. However there were no significant differences in the pathological examination results between DI 2. 5 group and DI 2. 5 group（ P 〈0. 05）. The detection rate of CIN of DNA quantitative cytology abnormality in age≥50 years group was higher than that in the other two groups,especially,the detection rate of CIN2 was 45. 5%. There were significant differences in DNA quantitive examination results among different age groups（ P 〈0. 01）. Conclusion The DNA ploid analysis in patients with HPV-negative ASCUS is helpful to detect CIN,which is an effective method for shunting action screening. Taking DI 5 as the criterion of cervical biopsy can enhance the detaction rate of CIN2 or higher grade CIN.

关 键 词：DNA倍体分析 不能明确意义的非典型鳞状上皮细胞 宫颈上皮内瘤变 

分 类 号：R711.74[医药卫生—妇产科学]