阴道镜及DNA定量分析和液基细胞学在宫颈病变筛查中的应用

Application of colposcopy combined with DNA quantitative analysis and liquid - based cytology in cervical lesions screening

目的探讨阴道镜及DNA倍体分析和液基细胞在宫颈疾病筛查中的应用价值。方法对8256例行妇科体检的已婚妇女采用阴道镜检查,对其中2180例行DNA倍体分析和液基细胞学检测,以活检病理诊断结果为标准,对病理结果进行分析。结果阴道镜在宫颈疾病诊断中敏感性为98.91%;特异性为22.84%;DNA倍体分析以中量以上DNA异倍体出现为活检标准,发现宫颈病变的敏感性为83.33%;特异性为68.47%;液基细胞学检查中以LSIL以上阳性作为活检标准,发现宫颈病变的敏感性为75.00%;特异性为88.62%。结论阴道镜及DNA倍体分析和液基细胞学在宫颈疾病筛查中均有较高的临床诊断价值,联合检查更能有效的提高宫颈病变的检出率。

Objective To explore the clinical application of colposcopy in combination with liquid based cytology and DNA quantitative analysis in cervical lesion screening.Methods 8256 married women adopted colposcope examination,among 2180 cases adopted liquid-based cytology and DNA quantitative analysis,using histological diagnosis as the gold standard.Results The sensitivity for colposcopy diagnosis of CIN was 98.91% and the specificity was 22.84%.For the standardbiopsy with more than three DNA-aneuploidies（moderate quantity） as the criteria,the sensitivity of cervical lesions was 83.33%,and specificity was 68.47%.Liquid-based cytology used the low grade squamous intraepithelial lesion（LISL） and high grade squamous intraepithelial lesion（HISL） as standards,the sensitivity was 75.00% and specificity was 88.62%.Conclusion Colposcopy in combination with liquid-based cytology and DNA quantitative analysis are of diagnosis value in cervical lesion screening.The combined use of these means could be more effective for the detection of cervical lesions.