宫颈液基薄层细胞学检查联合DNA倍体细胞检测筛查宫颈疾病的临床价值

Screening Value of Thinprep Cytologic Test and DNA Ploidy Analysis for Cervical Diseases

目的:探讨液基薄层细胞学检查(TCT)联合DNA倍体细胞检测在普查宫颈疾病中的临床价值。方法:分析2010年5月-2011年5月在我院妇女保健科完成宫颈TCT联合DNA倍体细胞检测的已婚妇女6 747例,对347例宫颈TCT检查阳性患者及262例DNA倍体细胞检测阳性(扫描结果3个以上>5C非整倍体细胞)患者行阴道镜检查,依据病理结果分析符合率。结果:未明确意义的不典型鳞状细胞(AS-CUS)177例,低度鳞状上皮内病变(L-SIL)106例,高度鳞状上皮内病变(H-SIL)64例,同时接受DNA倍体细胞检测阳性率分别为61.0%,84.9%,100%。AS-CUS组的DNA倍体细胞检测阳性率与L-SIL、H-SIL之间的差异有统计学意义(P<0.05)。TCT阳性347人,病理学检查(病检)阳性74人,符合率21.3%,TCT及DNA倍体细胞检测均阳性262人,病检阳性92人,阳性符合率35.1%。两组与病检符合率比较,差异有统计学意义(P<0.05)。且随着病理级别升高,TCT及DNA倍体细胞均阳性检出率也越来越高。结论:宫颈TCT检测联合DNA倍体细胞检测,能有效提高宫颈疾病的检出率,结合病理检查,可早期发现宫颈癌前病变,是普查宫颈疾病的可靠方法。

Objective： To explore the clinical value of combined screening of cervical diseases with thin- prep cytologic test （TCT） and DNA ploidy analysis. Methods： The clinical data of 6 747 women in our hospital who received both TCT and DNA ploidy analysis from May 2010 to May 2012 were reviewed in our study, and 347 women with positive TCT and 262 women with positive DNA aneuploid were examined with virginal endoscopy. Results： In the 177 cases of AS-CUS, 106 cases of L-SIL, and 64 cases of H-SIL, DNA aneuploid positive rate was 61.0%, 84.9%, 100% ,respectively. And the positive rate was different significantly between the AS-CUS group and L-SIL or H-SIL group （P〈0.05）. The coincidence rate to pathology was 21.3% （74/347） in 347 positive TCT women, while the rate was 35.1% （92/262） in combination of TCT and DNA ploidy analysis （P〈0.05）. The positive rate increased with the increased degree of pathology both in TCT and DNA ploidy analysis. Conclusion： The combination of TCT and DNA ploidy a- nalysis was reliable for detecting cervical diseases.