细胞DNA定量分析技术在宫颈癌及癌前病变早期筛查中的应用价值

Application of DNA image cytometry in the cervical intraepithelial neoplasia and cervical cancer screening

目的探讨细胞DNA定量分析技术在宫颈癌及癌前病变早期筛查中的应用价值。方法对23698例参加宫颈癌筛查的适龄女性采用宫颈刷取材,宫颈液基细胞学制片2张,一张用硫堇-Feulgen染色后,采用细胞DNA定量分析系统对细胞核DNA含量进行定量检测;另一张行巴氏染色做常规细胞学检查。任一个结果为阳性均建议行阴道镜或阴道镜指导下取活检,以活检结果作为金标准比较二种方法检测的准确性。结果随访到活检结果者221例,其中细胞DNA定量分析检测出198例阳性,常规细胞学检测出78例阳性,活检发现CIN2以上病变100例,细胞DNA倍体定量分析相对敏感性为96%,相对特异性99.6%,常规细胞学检测相对敏感性为40%,相对特异性为99.8%,虽然阳性预测值略高于细胞DNA倍体定量分析技术,但是有25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,在宫颈癌早期筛查中具有重要的应用价值,可作为宫颈癌筛查的方法之一。

Objective To evaluate the application of DNA image cytometry in the cervical intraepithelial neoplasia and cervical cancer screening.Methods 23 698 women were involved in this study.The samples were taken by cervix brush and prepared for 2 slides： one was stained by Pap staining and read by cytologist.The other was stained with Thionin-Feulgen staining and tested by DNA image cytometry.Results 221 biopsy results were avaliable.The sensitivity and specificity of DNA image cytometry were 96% and 99.6%,both of them of the cytology were 40% and 99.8%.Although the PPV of cytology was a little more than DNA image cytometry,but there were 25 false negative cases with cytology alone.Conclusion DNA image cytometry has more sensitivity and good specificity.It can be used in cervical cancer screening.