宫颈DNA倍体分析联合液基薄层细胞学检查在宫颈病变筛查中的应用价值  

Application value of cervical DNA ploidy analysis combined with thinprep cytologic test in cervical lesions screening

作　　者：李迎宾 白忻如 张欢欢[1] 杜艳敏[1] 曾宪旭[1] LI Yingbin;BAI Xinru;ZHANG Huanhuan;DU Yanmin;ZENG Xianxu(Pathology Department,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院病理科,河南郑州450052

出　　处：《临床医学研究与实践》2022年第34期131-134,共4页Clinical Research and Practice

摘　　要：目的探究宫颈DNA倍体分析联合液基薄层细胞学检查(TCT)在宫颈病变筛查中的应用价值。方法回顾性选择2018年12月至2020年3月于郑州大学第三附属医院行宫颈病变筛查的8938例女性,均给予宫颈DNA倍体分析、TCT及阴道镜活检。统计不同宫颈病变筛查方法的结果;以阴道镜活检为金标准,比较宫颈DNA倍体分析、TCT单独及联合筛查对宫颈病变的检查结果及诊断效能。结果8938例女性脱落细胞的阴道镜活检结果显示,正常宫颈组织6863例,宫颈上皮内瘤变(CIN)1级1091例,CIN 2级457例,CIN 3级392例,宫颈癌135例;宫颈DNA倍体分析结果显示,阴性6025例,阳性2913例;TCT结果显示,无上皮内病变或恶性病变(NILM)6159例,非典型鳞状上皮细胞(ASC-US)1484例,低级别鳞状上皮内瘤变(LSIL)974例,高级别鳞状上皮内瘤变(HSIL)321例。8938例女性脱落细胞的阴道镜活检结果显示,阳性984例,阴性7954例;宫颈DNA倍体分析结果显示,阴性6025例,阳性2913例,阳性率为32.59%;TCT结果显示,阳性2779例,阴性6159例,阳性率为31.09%;联合筛查结果显示,阴性5944例,阳性2994例,阳性率为33.50%。宫颈DNA倍体分析、联合筛查对宫颈病变的诊断灵敏度、阳性预测值、阴性预测值高于TCT,差异具有统计学意义(P<0.05);联合筛查对宫颈病变的诊断灵敏度、阳性预测值、阴性预测值高于宫颈DNA倍体分析,差异具有统计学意义(P<0.05)。结论宫颈DNA倍体分析联合TCT作为一种较可靠的宫颈病变筛查方法,灵敏度及阴性预测值较高,可提高宫颈癌及癌前病变的早期检出率。Objective To explore the application value of cervical DNA ploidy analysis combined with thinprep cytologic test(TCT)in cervical lesions screening.Methods A total of 8938 female who underwent cervical lesions screening in the Third Affiliated Hospital of Zhengzhou University from December 2018 to March 2020 were retrospectively selected.All of them underwent cervical DNA ploidy analysis,TCT and colposcopic biopsy.The results of different cervical lesions screening methods were counted;the results and diagnostic efficacy of cervical DNA ploidy analysis,TCT single and combined screening for cervical lesions were compared with colposcopic biopsy as the gold standard.Results The colposcopic biopsy results of 8938 female exfoliated cells showed that 6863 cases were normal cervical tissues,1091 cases were cervical intraepithelial neoplasia(CIN)grade 1,457 cases were CIN grade 2,392 cases were CIN grade 3,and 135 cases were cervical cancer;the results of cervical DNA ploidy analysis showed that 6025 cases were negative and 2913 cases were positive;TCT results showed that there were 6159 cases with negative for intraepithelial lesion or malignancy(NILM),1484 cases with atypical squamous cells of undetermined significance(ASC-US),974 cases with low grade squamous intraepithelial lesion(LSIL),and 321 cases with high grade squamous intraepithelial lesion(HSIL).The colposcopic biopsy results of 8938 female exfoliated cells showed that 984 cases were positive and 7954 cases were negative;the results of cervical DNA ploidy analysis showed that 6025 cases were negative,2913 cases were positive,and the positive rate was 32.59%;TCT results showed that 2779 cases were positive,6159 cases were negative,and the positive rate was 31.09%;the results of combined screening showed that 5944 cases were negative,2994 cases were positive,and the positive rate was 33.50%.The diagnostic sensitivity,positive predictive value,negative predictive value of cervical DNA ploidy analysis and combined screening for cervical lesions were higher than t

关 键 词：宫颈病变筛查 宫颈癌 宫颈DNA倍体分析 液基薄层细胞学检查 阴道镜活检 

分 类 号：R711.74[医药卫生—妇产科学]