细胞DNA倍体分析对宫颈高度鳞状上皮内病变诊断及随访价值研究  

Clinical significance of high-risk DNA ploidy analysis in screening of HSIL + and follow-up of HSIL

作　　者：罗丽丽 王莹[2] 罗小婉 孙佳星[2] 李玉鹏 侯梦月 

机构地区：[1]广东医科大学研究生学院妇产科,广东湛江524000 [2]南方医科大学附属中山市博爱医院,广东中山528400

出　　处：《中国优生与遗传杂志》2017年第9期22-24,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨细胞DNA倍体分析对宫颈高度鳞状上皮内病变HSIL+的诊断价值及HSIL-的随访意义。方法收集2013年1月至2014年12月在中山市博爱医院常规行宫颈癌筛查的妇女共1576例,均行液基细胞学检查(TCT)+细胞DNA倍体分析。任一结果阳性均行阴道镜活检,定义病理结果≥HSIL为病理阳性,<HSIL为病理阴性。结合TCT及活检病理结果,分析细胞DNA倍体分析诊断HSIL+的价值及细胞DNA倍体分析对HSIL-的随访价值。结果 (1)1576例受检妇女细胞DNA倍体分析阳性率15.6%,TCT阳性率9.33%。阴道镜转诊率21.45%。(2)不同病理分级DNA异倍体细胞数(N)差异有统计学意义(χ2=259.5,P=0.000)。细胞DNA异倍体数(N)与宫颈病变严重程度呈正相关(r=5.322,P=0.000)。各年龄分组中细胞DNA倍体分析阳性率差异有统计学意义(χ~2=173.224,P<0.01)。(3)细胞DNA倍体分析敏感度81.03%,TCT敏感度32.76%,差异有统计学意义(χ2=27.559,P<0.01);细胞DNA倍体分析联合TCT检测敏感度可达87.93%。(4)对病理阴性患者随访2年可知,细胞DNA倍体阳性患者较阴性患者罹患HSIL+的风险高(P<0.05)。结论细胞DNA倍体分析在宫颈癌筛查中对HSIL+的诊断及HSIL-的随访均有较高的临床价值,细胞DNA倍体分析联合TCT用于宫颈癌初筛优于单独的筛查方法。Objective：To investigate the diagnostic value of cell DNA ploidy analysis in the diagnosis of cervical high squamous intraepithelial lesion（HSIL）＋ and the follow-up significance of HSIL-. Methods： A total of 1576 women were screened from January 2010 to December 2013 at the Pangai Hospital of Zhongshan City. All of them were examined by liquid-based cytology（TCT）and DNA ploidy. Any of the results were positive colposcopy biopsy,the definition of pathological results≥ HSIL as pathologically positive,HSIL for pathological negative. Combined with TCT and biopsy results,analysis of cell DNA ploidy analysis of the value of HSIL ＋ diagnosis and cell DNA ploidy analysis of HSIL-follow-up value. Results：（1）The positive rate of DNA ploidy analysis in 1576 cases was 15.6% and the positive rate of TCT was 9.33%. Colposcope referral rate of 21.45%.（2）There were significant differences in the number of aneuploid cells（N）between different pathological grades（χ2 = 259.5,P=0.000）. The number of DNA aneuploid（N）was positively correlated with the severity of cervical lesions（r= 5.322,P= 0.000）. There was significant difference in the positive rate of DNA ploidy analysis among different age groups（χ2 = 173.224,P〈 0.01）.（χ2= 27.559,P〈 0.01）. The sensitivity of DNA ploidy analysis combined with TCT was 87.93%,and the sensitivity of DNA ploidy was 81.03% and the sensitivity of TCT was 32.76%.（4）Follow-up of pathologically negative patients showed that patients with DNA ploidy were more likely to develop HSIL ＋ than those with negative patients（P〈 0.05）.Conclusion：The DNA ploidy analysis of the cells has a high clinical value in the diagnosis of HSIL ＋ and the follow-up of HSIL-in cervical cancer screening. Cell DNA ploidy analysis combined with TCT for cervical cancer screening is superior to the individual screening method.

关 键 词：细胞DNA倍体分析技术 薄层液基细胞学检测 宫颈高度鳞状上皮内病变 随访 

分 类 号：R737.33[医药卫生—肿瘤]