DNA倍体分析联合HPV-DNA 23分型检测对ASC-US的诊断价值  

Diagnostic value of DNA ploidy analysis combined with HPV-DNA 23 typing for atypical squamous cells of undetermined significance

作　　者：孙春杰 余小蒙[2] 张欣荣 岳欣 刘明依 任雨桐 SUN Chun-jie;YU Xiao-meng;ZHANG Xin-rong;YUE Xin;LIU Ming-yi;REN Yu-tong(Department of Pathology,Tongzhou Maternal&Child Health Hospital of Beijing,Beijing 101101,China;Department of Pathology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Science and Education Division,Tongzhou Maternal&Child Health Hospital of Beijing,Beijing 101101,China)

机构地区：[1]北京市通州区妇幼保健院病理科,北京101101 [2]首都医科大学附属北京友谊医院病理科,北京100050 [3]北京市通州区妇幼保健院科教科,北京101101

出　　处：《临床与实验病理学杂志》2021年第6期694-698,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨DNA倍体分析联合HPV-DNA 23分型检测(HPV检测)对子宫颈液基细胞学涂片(liquid-based preparation,LBP)报告的“不能明确意义的非典型鳞状细胞(atypical squamous cells of undetermined significance,ASC-US)”的诊断价值。方法收集64例ASC-US子宫颈细胞样本,制成LBP薄片2张,1张用于巴氏染色进行LBP TBS分级诊断,1张用于Feulgen染色进行DNA倍体分析,同样方法进行HPV检测;检测结果经子宫颈组织活检验证。结果64例ASC-US经活检验证,其中22例阴性,为正常或炎症;42例阳性,包括低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)21例、高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)+癌(鳞状细胞癌1例)21例,阳性率为65.63%。在42例病理结果阳性中:DNA倍体分析和HPV检测共阳性22例,占比34.38%(22/64);DNA倍体分析或HPV检测阳性20例,占比31.25%(20/64);在21例HSIL+癌中,DNA倍体分析或HPV检测阳性6例,占比9.38%(6/64)。在22例病理结果阴性中:DNA倍体分析+HPV检测共阳性4例,占比6.25%(4/64);DNA倍体分析或HPV检测阳性15例,占比23.44%(15/64);DNA倍体分析+HPV检测共阴性3例,占比4.69%(3/64)。结论在LBP诊断ASC-US病例中,其DNA倍体分析和(或)HPV检测阳性时建议转诊阴道镜;而DNA倍体分析和HPV检测共阴性时建议采用常规LBP复查。DNA倍体分析联合HPV检测对子宫颈LBP筛查报告中的ASC-US病例具有辅助诊断价值。Purpose To explore the diagnostic value of DNA ploidy analysis(DNA)combined with HPV-DNA 23 typing test(HPV test)for“atypical squamous cells of undetermined significance(ASC-US)”of cervical liquid-based preparation(LBP).Methods The cervical cell samples from 64 ASC-US patients were collected with a cervical brush,and two LBP slices were prepared.One was used for Pap staining for LBP TBS grading diagnosis,the other was used for Feulgen staining for DNA ploidy analysis,and the same method was used for HPV test.The test results were confirmed by a cervical biopsy.Results Sixty-four ASC-US cases were confirmed by biopsy,in which 22 cases were negative with chronic inflammation.42 cases were positive,which included 21 cases of low-grade squamous intraepithelial lesions(LSIL)and 21 cases of high-grade squamous intraepithelial(HSIL)or more serious lesions(1 case of squamous cell carcinoma),with a positive rate of 65.63%.Among the 42 positive cases,22 were both positive for DNA and HPV test,accounting for 34.38%of ASC-US.20 cases were positive either for DNA or HPV test,accounting for 31.25%of ASC-US.Among the 20 HSIL and 1 cancer,6 cases were positive either for DNA or HPV test,accounting for 9.38%(6/64).Among the 22 negative cases,4 cases were both positive for DNA and HPV test,accounting for 6.25%of ASC-US.15 cases were positive either for DNA or HPV test,accounting for 23.44%of ASC-US.3 cases were negative for both DNA and HPV test,accounting for 4.69%of ASC-US.Conclusion In cases of ASC-US diagnosed by LBP,a referral to colposcopy is recommended for DNA ploidy analysis and/or HPV test.Routine LBP review is recommended when DNA ploidy analysis and HPV test are negative.DNA ploidy analysis combined with HPV test has auxiliary diagnostic value for ASC-US cases reported in cervical LBP screening.

关 键 词：子宫颈肿瘤 不能明确意义的非典型鳞状细胞 DNA倍体分析 HPV-DNA 23分型检测 

分 类 号：R737.33[医药卫生—肿瘤]