摘要
目的探讨DNA异倍体定量检测在宫颈病变妇女分流诊治的临床价值。方法回顾性研究,选择宫颈早期病变筛查中1404例中老年妇女,根据患者年龄分为40~49岁组897例,50~78岁组507例。采用DNA倍体分析技术筛查宫颈病变,并与液基细胞学技术、阴道镜检查和高危型人乳头状瘤病毒(HPV)检查的结果比较。结果HPV检测阳性检出率为54.4%(764例),其中HPV16/18感染占21.3%(299例),异倍体细胞的检出率为50.9%(715例),HPV感染类型与宫颈上皮细胞倍体变化呈正相关(r=870,P=0.001)。液基细胞学检查检出率为45.1%(633例),低于DNA异倍体检出率50.9%(715例),差异有统计学意义(χ^2=9.594,P=0.002)。有DNA异倍体和无DNA异倍体发生宫颈低级别鳞状上皮内病变(LSIL)和高级别鳞状上皮内病变(HSIL)及以上病变患者比较差异有统计学意义(χ^2=289.598,P=0.000)。40~49岁组与50~78岁组人群出现DNA倍体异常细胞、HPV感染率、发生LSIL及HSIL及以上病变的比例比较差异有统计学意义(P<0.05)。结论DNA异倍体定量检测较常规细胞学具有较高的敏感性,特异性较好,与高危型HPV检查无差异,可作为中老年女性筛查宫颈病变特别是伴有高危型HPV感染的方法之一。
Objective To investigate the clinical value of quantitative detection of DNA aneuploidy in the diagnosis and treatment of cervical lesions in middle-aged and senile women.Methods A total of 1404 middle-aged and elderly women who underwent screening for early cervical lesions were retrospectively studied.Patients were divided into the two groups:the 40-49 years old group(n=897)and the 50-78 years old group(n=507).Cervical lesions were screened by DNA ploidy analysis and the results were compared with those screened by liquid-based cytology,colposcopy and high-risk human papillomavirus(HPV).Results The positive detection rate of HPV by DNA ploidy analysis was 54.4%(764/1404).Of 1404 patients,HPV16/18 infection accounted for 21.3%(299/1404).The detection rate of heteroploid cells was 50.92%(715/1404).There was a significant positive correlation between HPV infection type and cervical epithelial cell ploidy changes(r=870,P=0.001).The detection rate of HPV by liquid-based cytology was 45.08%,which was lower than that by DNA aneuploidy(χ^2=9.594,P=0.002).The differences in the incidences of low-grade squamous intraepithelial lesion(LSIL)and high-grade squamous intraepithelial lesion(HSIL)and above categories of lesions were statistically significant(χ^2=289.598,P=0.000)between patients with and without DNA aneuploidy.The statistically significant differences were found between the 40-49 years old group and 50-78 years old group(P<0.05)in the occurrence of abnormal DNA ploidy cells,HPV infection rate,the proportion of LSIL,HSIL and above categories of lesions.Conclusions Compared with the conventional cytology,DNA aneuploidy quantitative detection has higher sensitivity and better specificity,and has no significant difference from the high-risk HPV detection.It can be used as one of methods for screening cervical lesions in middle-aged and elderly women,especially those with high-risk HPV infection.
作者
王立锋
朱昀恒
朱修香
夏子茵
徐灵
Wang Lifeng;Zhu Yunheng;Zhu Xiuxiang;Xia Ziyin(Department of Obstetrics and Gynecology,Central Hospital of Minhang District,Shanghai 201199,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2019年第11期1285-1288,共4页
Chinese Journal of Geriatrics
基金
上海市卫计委科研项目(201840340)。
关键词
DNA异倍体
宫颈肿瘤
乳头状瘤病毒感染
DNA aneuploid
Uterine cervical neoplasms
Papillomavirus infections
