DNA倍体分析对宫颈低度鳞状上皮内病变的诊断价值

Diagnostic value of nuclear DNA ploidy analysis in low-grade squamous intraepithelial lesion

目的为宫颈低度鳞状上皮内病变(LSIL)的临床诊治寻求一项合理而客观的区分方法。方法选取212例液基薄层细胞学诊断为LSIL病例样本,每个样本均行宫颈脱落细胞核DNA倍体分析和阴道镜下宫颈活检。在DNA倍体分析阳性病例中,以>5C细胞或有异倍体细胞峰出现为分流指标,>5C细胞或有异倍体细胞峰的为A组,<5C细胞或无异倍体细胞峰的为B组,比较两组间CIN的发生率。结果 DNA倍体分析阳性病例中,A组119例,B组51例;A组和B组CIN的发生率分别为99.12%及21.57%,两组比较有显著性差异(χ2=117.40,P=0.000<0.01)。结论 DNA倍体分析可以对LSIL患者进行筛查分流,以>5C细胞或有异倍体细胞峰为分流指标,是合理的、客观的,>5C细胞或异倍体细胞峰出现的建议阴道镜下活检,<5C细胞或无异倍体细胞峰出现的则建议3～6个月随诊复查。

Objective To find a reasonable and objective standard for distinguish the low-grade squamous intraepithelial lesions （LSIL） by using nuclear DNA ploidy analysis. Methods Selected 212 cases of thinPrep cytology cases diagnosed as LSIL samples, each sample underwent cervical nuclear DNA ploidy analysis and eolposeopy and biopsy. With〉5C （DNA Index 〉 215） cells or aneuploid of shunt index in positive cases by DNA ploidy analysis, 〉5C ceils or aneuploid for the group A, 〈5C cells or non-aneuploid for the B group, compared the two groups between the incidence of CIN. Results In the positive cases by DNA ploidy analysis, A group of 119 ＇cases, B group of 51 patients; A and B groups of CIN rates were 99.12% and 21.57%, the two groups was significant statistical difference （χ2=117.40, P=0.000〈0.01）. Conclusion It was a reasonable and objective standard to distinguish the low-grade squamous intraepithelial lesions （LSIL） by using nuclear DNA ploidy analysis with 〉 5C cells or aneuploid. All cases with 〉5C cells or aneuploid decided by automated.DNA imaging cytometry were sent to colposcopy and biopsy, and the cases with 〈5C cells or non-aneupluid were recommended to 3 to 6 months of follow-up review.