细胞DNA定量分析联合液基细胞学检测在宫颈癌早期筛查中的应用

Application of Cell DNA quantitative analysis combined with liquid-based cytology in screening of early cervical cancer

目的探讨DNA定量分析结合液基细胞学检测在宫颈早期病变筛查中的价值。方法收集我院完成DNA定量分析及液基细胞学检测的患者839例,每例患者液基制片1张,行Feulgen-E染色观察且完成DNA定量分析。以病理诊断为金标准,对两种诊断方法在宫颈癌早期筛查中的价值进行综合评价。结果 839例宫颈脱落细胞样本中,以1-2个倍体异常细胞为DNA定量分析的标准,发现DNA检测CINⅠ以上的灵敏度为91.80%,CINⅡ以上的灵敏度为96.67%;以意义不明确的非典型鳞状细胞(ASC-US)为液基细胞学检查的标准,发现液基细胞学检测CINⅠ以上的灵敏度为81.97%,检测CINⅡ以上的灵敏度为90.91%。因此,随着DNA检查中倍体异常细胞数量增加,液基细胞学检查的阳性率也相应增加,两种检测方法的结果均呈阳性者,其检查结果与活检病理检查具有较高的符合率。DNA定量分析与液基细胞学联合检测与单独液基细胞学或DNA定量分析检测灵敏度进行比较,差异有统计学意义(P<0.05)。结论 DNA定量分析与液基细胞学联合检测可提高宫颈早期病变筛查的灵敏度,减少误诊或漏诊等情况的发生机率。

Objective:To explore the value of DNA quantitative analysis combined with liquid based cytology in screening for early cervical lesions. Methods:A total of 839 patients who underwent DNA quantitative analysis and liquid-based cytology examination in our hospital were collected. One liquid-based section was made and stained with Feulgen-E for routine diagnosis by cytologists and DNA quantitative analysis. The significance of the two diagnostic methods in screening of early cervical cancer were evaluated by using pathological diagnosis as the gold standard. Result:Among 839 samples of cervical exfoliated cells,Using 1-2 polyploid abnormal cells as the standard of DNA quantitative analysis,it was found that the sensitivity of DNA detection was 91.80% for CIN I and 96.67% for CIN II. Using atypical squamous cells(ASC-US)with unclear significance as the standard of liquid-based cytology,liquid-based cells were found. The sensitivity of detection of CIN I and CIN II was 81.97% and 90.91% respectively. With the increase of the number of polyploid abnormal cells in DNA examination,the positive rate of liquid-based cytology examination increased correspondingly. The results of both methods were positive,and the coincidence rate between the two methods was high. There was a significant difference about the sensitivity between the detection of DNA quantitative analysis and liquid-based cytology combined with single liquid-based cytology or DNA quantitative analysis(P<0.05). Conclusion:DNA quantitative analysis and liqid-based cytology combined detection and diagnosis can improve the sensitivity of early cervical lesion screening,reduce the incidence of misdiagnosis or missed diagnosis.