宫颈DNA倍体分析对新疆维吾尔族宫颈癌的早期诊断价值  

Cervical DNA ploidy analysis in early diagnosis of cervical cancer in Xinjiang Uygur women

作　　者：张庆悦[1] 夏日瓦娜·阿巴斯 杨秀玮[1] 张淑萍 ZHANG Qing-yue;Shariwana ABBAS;YANG Xiu-wei;ZHANG Shu-ping(Department of Gynecology,the First People's Hospital of Kashgar,Kashgar,Xinjiang Uygur Autononwus Region 844000,China)

机构地区：[1]喀什地区第一人民医院妇科,新疆维吾尔自治区喀什844000

出　　处：《中华实用诊断与治疗杂志》2021年第4期363-366,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：新疆维吾尔自治区自然科学基金(2017D01C004)。

摘　　要：目的探讨宫颈DNA倍体分析对新疆维吾尔族宫颈癌的早期诊断价值及其与宫颈癌病理分期的相关性。方法接受宫颈筛查的新疆维吾尔族女性300例,组织病理学检查确诊为宫颈癌患者100例(宫颈癌组)、癌前病变患者200例(宫颈上皮内瘤变100例、慢性宫颈炎100例)(良性组),比较2组患者宫颈DNA倍体定量水平及临床资料;采用多因素logistic回归分析宫颈癌发生的影响因素;绘制ROC曲线,评估宫颈DNA倍体分析法对宫颈癌病变早期的诊断效能;比较宫颈癌不同病理分期患者宫颈DNA倍体定量水平,采用Spearman相关分析宫颈DNA倍体定量水平与宫颈癌病理分期的相关性。结果宫颈癌组患者妊娠次数[(3.14±0.26)次]多于良性组[(1.13±0.19)次](P<0.05),性伴侣数量≥2个比率(81.00%)、人类乳头瘤病毒(human papillomavirus, HPV)感染比率(54.00%)及宫颈DNA倍体定量水平[(5.64±0.47)5cER]高于良性组[32.50%、25.00%、(2.42±0.25)5cER](P<0.05),对HPV疾病完全知晓比率(17.00%)低于良性组(34.00%)(P<0.05)。性伴侣数量(OR=1.874,95%CI:1.785~1.963,P=0.004)、妊娠次数(OR=2.863,95%CI:2.052~3.674,P=0.008)、HPV感染(OR=4.674,95%CI:3.472~5.876,P=0.003)、HPV疾病认知程度(OR=2.599,95%CI:1.857~3.341,P<0.001)、宫颈DNA倍体定量水平(OR=2.565,95%CI:1.777~3.353,P<0.001)是宫颈癌发生的影响因素。宫颈DNA倍体定量水平的最佳截断值为4.41 5cER时,诊断宫颈癌早期的AUC为0.788(95%CI:0.705~0.883,P<0.001)。宫颈细胞DNA倍体定量水平与宫颈癌病理分期呈正相关(r=0.789,P<0.001)。结论宫颈DNA倍体分析对新疆维吾尔族宫颈癌的早期诊断有一定价值,宫颈细胞DNA倍体定量水平与宫颈癌病理进展具有正相关性,可作为宫颈癌病变早期诊断的方法。Objective To explore the application value of cervical DNA ploidy analysis in the early diagnosis of cervical cancer in Xinjiang Uygur women and its correlation with pathological grades. Methods Totally 300 Xinjiang Uygur women undergoing cervical screening were divided into 100 cases of cervical cancer(cervical cancer group) and 200 cases of precancerous lesions(100 cases of cervical intraepithelial neoplasia and 100 cases of chronic cervicitis)(benign group) according to the histopathological examination results. The cervical DNA ploidy count and the clinical data were compared between two groups. The influencing factors of cervical cancer were analyzed by multivariate logistic regression analysis. ROC was drawn to evaluate the efficacy of cervical DNA ploidy analysis on early diagnosis of cervical cancer. The quantitative level of cervical DNA ploidy was compared in patients with different pathological grades of cervical cancer. Spearman correlation coefficient was used to analyze the correlation between the quantitative level of cervical DNA ploidy and pathological grades of cervical cancer. Results The number of pregnancy was larger in cervical cancer group(3.14±0.26) than that in benign group(1.13±0.19)(P<0.05). The percentages of sexual partners ≥2, human papillomavirus(HPV) infection rate and cervical DNA ploidy quantitative level were higher in cervical cancer group(81.00%, 54.00%,(5.64±0.47) 5 cER) than those in benign group(32.50%, 25.00%,(2.42±0.25) 5 cER)(P<0.05), and the rate of full knowledge of HPV disease was lower in cervical cancer group(17.00%) than that in benign group(34.00%)(P<0.05). The number of sexual partner(OR=1.874, 95%CI: 1.785-1.963, P=0.004), the number of pregnancy(OR=2.863, 95%CI: 2.052-3.674, P=0.008), HPV infection(OR=4.674, 95%CI: 3.472-5.876, P=0.003), knowledge of HPV diseases(OR=2.599, 95%CI: 1.857-3.341, P<0.001) and cervical DNA ploidy quantitative level(OR=2.565, 95%CI: 1.777-3.353, P<0.001) were the influencing factors of cervical cancer. When the optimal cut-off

关 键 词：宫颈癌 宫颈DNA倍体分析 维吾尔族 相关性 病理分期 

分 类 号：R737.33[医药卫生—肿瘤]