摘要
目的:探讨宫颈上皮内病变(CIN)与中医证候的关系,以及细胞DNA倍体分析系统对本病诊断的应用价值。方法:对389例行宫颈液基细胞学(TCT)检查的患者进一步分析临床中医证候分型,同时对TCT的剩余标本均采用细胞DNA倍体分析系统进行再分析,以病理诊断结果为金标准。分析DNA倍体分析系统在宫颈上皮内病变中的诊断价值以及本病的中医证候分布关系。结果:1389例患者中CIN共247例,其中脾虚湿困型66例、阴虚夹湿型29例、湿热下注型67例、肾阳虚型29例、湿毒蕴结型56例。宫颈上皮内病变(CIN)在不同中医证型中的分布有统计学意义(P<0.05)。2389例患者中,不明意义非典型鳞状上皮(ASC-US)169例,非典型鳞状细胞、不除外上皮内高度病变(ASC-H)10例,低度鳞状上皮内病变(LSIL)132例,高度鳞状上皮内病变(HSIL)61例,鳞状细胞癌(SCC)17例。DNA倍体分析共检出宫颈上皮细胞DNA倍体异常者287例。病理活检中CINⅠ级156例,CINⅡ级54例,CINⅢ级37例,宫颈癌27例。以CINⅠ级及以上病变为阳性检出率,其中液基细胞学检查为LSIL及以上级别作为评估CINⅠ级及以上病理改变为标准,其敏感性、特异性、阳性预测值、阴性预测值分别为66.42%、66.96%、82.73%、45.56%;DNA倍体分析系统以出现DNA异倍体细胞作为评估CINⅠ级及以上病理改变为标准,其敏感性、特异性、阳性预测值、阴性预测值分别为90.15%、65.22%、86.06%、73.53%。结论:宫颈上皮内病变在不同中医证候中的分布有一定统计学意义;细胞DNA倍体分析能有效提高宫颈癌筛查的阳性检出率。
Objective：To explore the relationship between cervical intraepthelial neoplasm（CIN） and traditional Chinese medicine（TCM） syndromes,and the importance of DNA ploidy analysis system for the diagnosis of this disease. Method：There were 389 people given cervical liquid-based cytology examination,and diagnosed to determine the clinical TCM syndrome type,while the remaining specimens were used for DNA ploidy analysis. Results of pathological examination were taken as gold standard. The importance of DNA ploidy for CIN and the TCM syndromes distribution in the disease were analyzed. Results：①In the 247 patients with CIN,spleen deficiency and dampness accounted for 66 cases,yin deficiency and dampness 29 cases,damp heat 67 cases,kidney yang insufficiency 29 cases,damp stagnation 56 cases. The distribution of CIN in different TCM syndromes had statistical significance（P〈0.05）. ②In 389 people,atypical squamous cells of undetermined significance accounted for 169 cases,atypical squamous cells without HSIL 10 cases,low-grade squamous intraepithelial lesions 132 cases,high-grade squamous intraepithelial lesions 61 cases,squamous cell carcinoma 17 cases. There were 287 people determined as polyploid cervical epthlial cells through DNA ploidy analysis. According to pathological examination,156 patients were of CIN Ⅰ,54 patients CIN Ⅱ,37 patients CIN Ⅲ,27 patients SCC. CIN Ⅰ and the above were positive,LSIL and the above level were used as standard to assess CIN Ⅰ and the above pathologic changes,with the sensitivity being 66.24%,the specificity 66.96%,the positive predictive value 82.73%,and the negative predictive value 45.56%. DNA ploidy analysis system and DNA polyploid cells were used as the standard to assess CIN Ⅰ and the above pathologic changes,with the sensitivity being 90.15%,the specificity65.22%,the positive predictive value 86.06%,and the negative predictive value 73.53%. Conclusion：The distribution of cervical intraepithelial lesions in different TCM syndromes was statistical
作者
张肖
高靖
张金虎
ZHANG Xiao GAO Jing ZHANG Jinhu(The Second Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan 250355, China The Second Affiliated Hospital,Shandong University of Traditional Chinese Medieine,Jinan 250000, China Clinical Medicine College, Weifang Medical University, Weifang 261053, China)
出处
《山东中医杂志》
2016年第12期1028-1031,共4页
Shandong Journal of Traditional Chinese Medicine
关键词
宫颈上皮内病变(CIN)
DNA倍体分析
中医证候
宫颈癌筛查
cervical intraepithelial lesion
DNA ploidy analysis
traditional Chinese medicine syndrome
screening cervical cancer
