细胞DNA倍体分析评价251例宫颈病变的临床研究

DNA Ploid Analysis on 251 Cases of Cervical Lesions

目的探讨细胞DNA倍体分析在宫颈病变诊断中的效果及与病理活检的差异。方法对251例患者采用病理活检及细胞DNA倍体分析两种方法作出宫颈病变诊断,并进行对比分析结果病理活检诊断251例患者中CINⅡ级及以下病变为212例,CINⅡ级以上病变为39例;细胞DNA倍体分析发现43例患者出现≥3个DNA异倍体细胞,30例患者出现非整倍体细胞峰,以上两种情况有临床意义。若以出现≥3个DNA异倍体细胞作为评估CINⅡ级累及腺体及以上病变的标准,其诊断性能评价指标较准确可靠,其敏感度为70.0%,特异度为77.1%,阳性预测值为31.5%,阴性预测值为94.3%;若以出现非整倍体细胞峰作为诊断CINⅡ级累及腺体病变及以上宫颈上皮内瘤变为标准则与病理活检相比无差异性。结论 DNA倍体分析可作为病理活检确诊宫颈病变的参考指标,为DNA倍体分析系统提供新的临床资料。

Objective To explore the diagnostic value of DNA image cytometry（DNA-ICM）in cervical lesions and compare the difference between DNA-ICM and pathologic biopsies.Methods 251 women with cervical lesions in Zhongshan hospital were all diagnosed by using pathologic biopsies and DNA-ICM respectively,and two methods were compared.Results 39 cases of cervical intraepithelial neoplasia Ⅱ（CINⅡ or over）out of 251 cases were diagnosed by pathologic biopsies.DNA ploid analysis demonstrated that 43 cases had 3 or more cells with DNA greater than 5C and 30 cases had aneuploid cell peak.More exact and reliable values could be obtained if 3 or more cells with DNA greater than 5C were assessed to diagnose CINⅡ or over lesions,and the sensitivity,specificity,positive predictive value and negative predictive value were 70.0%,77.1%,31.5% and 94.3%,respectively.There was no significant difference between DAN-ICM and biopsies if aneuploid cell peak was used as standard to diagnose CINⅡ or over.Conclusion DNA ploid analysis served as reference for diagnosing cervical lesions by biopsies and also provided extremely valuable data for DNA-ICM system.