细胞DNA倍体定量分析技术在宫颈癌普查中的应用价值

Cell quantitative analysis of DNA ploidy in cervical cancer screening

目的评价细胞DNA倍体定量分析技术在宫颈癌普查中的应用价值。方法对参与宫颈癌普查的7 735例女性采用宫颈刷取材。液基处理后制成标本片2张,分别进行巴氏染色和Feulgen-Thionin染色。对巴氏染色片做常规细胞学检查,用全自动细胞DNA倍体定量分析系统对Feulgen染色片行细胞核DNA定量分析。结果常规细胞学检查共发现269例异常,DNA倍体分析技术发现462例异常。共取活检776例,发现CINⅡ以上病变147例,DNA倍体分析技术只有1例CINⅡ漏诊,相对敏感性为83.6%,相对特异性为96.7%。采用常规细胞学检测相对敏感性为61.9%,相对特异性为98.3%,虽然阳性预期值略高于DNA倍体分析技术,但有29例漏诊。结论细胞DNA倍体定量分析技术较常规细胞学敏感性高,特异性也较好,可作为宫颈癌普查的方法之一。

Objective To evaluate the clinical value of automated DNA image cytometry in cervical cancer or pre-cancer detection.Methods A total of 7735 women were enrolled in the study.Samples were taken with a cervix brush and transported into a fixative solution.Two slides were made from each sample： one stained with Feulgen DNA specific stain and the other Pap stained.Results Based on 776 patients for whom colposcopically directed biopsies were read by 3 intern pathologists and using CIN2＋ histopathology as the positivity threshold and gold standard.The respective sensitivity and specificity were： 61.9% and 98.3% for conventional cytology;83.6% and 96.7% for DNA ploidy test.Conclusion Automated DNA image cytometry may be a useful tool for cervical cancer screening in developing countries and has a competitive sensitivity and specificity,compared with conventional cytology.