摘要
目的：探讨宫颈细胞DNA定量分析在已婚妇女宫颈癌早期筛查中的作用和意义。方法：同时运用细胞DNA定量分析技术与液基薄层细胞学检测（TCT）技术对已婚妇女进行宫颈癌筛查,检查结果阳性的患者给予阴道镜下宫颈活检进行病理确诊。结果：1000例妇女行宫颈细胞DNA定量分析共查出DNA倍体异常者188例（18.8%）,其中DNA异倍体1~2个101例,DNA异倍体≥3个87例,经宫颈活检病理诊断,DNA异倍体者确诊宫颈上皮内瘤变（CIN）Ⅰ~Ⅲ级共121例,宫颈癌12例,细胞DNA定量分析检测宫颈病变（CIN-Ⅲ及以上）的灵敏度为89.3%,特异度为18.5%,阳性预测值为13.3%,阴性预测值为92.5%;1000例妇女同时行液基薄层细胞学检测,查出异常者共65例（6.5%）,经活检病理诊断,液基薄层细胞学检查异常者确诊宫颈上皮内瘤变（CIN）Ⅰ~Ⅲ级27例,宫颈癌4例,液基薄层细胞学检测宫颈病变（CIN-Ⅲ及以上）的灵敏度为32.1%,特异度为72%,阳性预测值为13.8%,阴性预测值为88.3%。结论：宫颈细胞DNA定量分析灵敏度高于TCT,有助于宫颈癌及癌前病变的早期发现。
Objective： To investigate the clinical significance of applying cell DNA quantitative analysis to early screening of cervical cancer in married women.Methods： Both automated quantitative image cytometry and thinprep cytology test（ TCT） were random Ly performed to screen for early cervical cancer in the married women.Patients with positive findings were undergone cervical biopsy under the colposcope for following pathological verification.Results： In 1000 women received cervical cell DNA quantitative measurements,abnormal DNA ploid was detected in 188（ 18.8%）,in whom the heteroploid occurred between one and two in 101,and equal to or greater than three in 87.Pathological examination of the cervical biopsies in cases with heteroploidy cells indicated that 121 were cervical intraepithelial neoplasia（ CIN） Ⅰ-Ⅲ,and 12 were cervical cancer.Cervical cell DNA quantitative analysis screening cervical lesion（ CIN III and above） indicated that the sensitivity,specificity,positive predictive value（ PPV） and negative predictive value（ NPV） was 89.3%,18.5%,13.3% and 92.5%,respectively.TCT was also applied to 1000 women and revealed abnormal cell in 65 cases（ 6.5%）.Following pathology verified that 27 cases were CIN Ⅰ-Ⅲ and 4 cervical cancer.The sensitivity,specificity,PPV and NPV in screening cervical lesion（ CIN III and above） by TCT 32.1%,72%,13.8% and 88.3%,respectively. Conclusion： Cervical cell DNA quantitative analysis may reveal higher sensitivity than TCT.The findings suggest that this technique can be more competent in early detection of cervical cancer and precancerous lesions in married women.
作者
闻明
田德明
杨小苗
怀建国
WEN Ming TIAN Deming YANG Xiaomiao HUAI Jianguo(Department of Obstetrics ＆ Gynecology,Wuhu No. 1 People＇s Hospital, Wuhu 241001, China)
出处
《皖南医学院学报》
CAS
2016年第4期371-373,377,共4页
Journal of Wannan Medical College
基金
卫生部医药卫生科技发展研究中心基金项目(W2013GJ44)
