宫颈细胞DNA定量分析用于筛查宫颈病变的临床价值  

Clinical significance of DNA quantitative analysis technology of cervical cells in cervical lesion screening

作　　者：田澄 王志强 金玉兰[1] Tian Cheng;Wang Zhiqiang;Jin Yulan(Department of Pathology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院病理科,北京100006

出　　处：《中国医刊》2021年第3期281-284,共4页Chinese Journal of Medicine

摘　　要：目的探讨宫颈细胞DNA定量分析技术在宫颈病变筛查中的临床价值,寻求有效的意义不明的非典型鳞状上皮细胞(atypical squamous cell of undetermined signification,ASC-US)分流方法。方法对2019年1—6月于首都医科大学附属北京妇产医院参与筛查的13078例女性进行液基薄层细胞学检查(thin-prep cytology test,TCT)和细胞DNA定量分析,计算两种方法的阳性检出率及病理诊断宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅱ级以上病变的敏感性和特异性,对TCT诊断为ASC-US及以上的病例结合细胞DNA定量分析结果进行选择性活检。结果TCT阳性检出率为14.60%,DNA定量分析阳性检出率为15.30%。TCT和DNA定量分析诊断CINⅡ级以上病变的敏感度分别为92.20%、93.50%,特异度分别为77.30%、64.60%。TCT检查为ASC-US且DNA定量分析为阳性的84例患者活检发现21例CINⅠ级,11例CINⅡ级。结论TCT结合DNA定量分析技术可提高宫颈癌和癌前病变的筛查阳性率,降低漏诊率。ASC-US伴有DNA倍体异常者,检出CIN的风险增高。Objective To explore the clinical value of DNA quantitative analysis technology of cervical cells in cervical lesion screening and seek an effective ASC-US triage method.Method Liquid-based cytology and DNA quantitative analysis of cells were performed on 13078 women participated in the screening,and the positive detection rate of both methods and the sensitivity and specificity of pathological diagnosis of lesions above CINⅡ level were calculated.ASC-US with conventional cytological diagnosis combined with quantitative cellular DNA analysis was performed selective biopsies.Result The positive rate of conventional cytology was 14.60%,and the positive rate of DNA quantitative analysis was 15.30%.Combined TCT with DNA quantitative analysis,the sensitivity of lesions above CINⅡ was 92.20% and 93.50%,and the lesion specificity of above CINⅡ was 77.30% and 64.60%,respectively.Combining ASC-US with DNA quantitative analysis,we found 21 cases CINⅠ and 11 cases CINⅡ in 84 cases biopsies.Conclusion Combined TCT with DNA quantitative analysis technology could improve the positive rate of screening for cervical cancer and precancerous lesions and reduce the rate of missed diagnosis.And the detection risk of CIN lesions was increased in ASC-US with DNA ploidy abnormalities.

关 键 词：宫颈细胞DNA定量分析 液基薄层细胞学检查 常规细胞学 宫颈病变 宫颈癌 

分 类 号：R737.3[医药卫生—肿瘤]