DNA倍体分析在非典型鳞状上皮细胞分流诊断中的应用

Application of DNA Ploidy Analysis in the Diagnosis of ASCUS

目的:评价DNA倍体分析在不能明确意义的非典型鳞状上皮细胞(ASCUS)病人分流诊断中的意义。方法:对2012年8月至2013年9月,液基薄层细胞学检查(TCT)诊断为ASCUS的141例患者进行DNA倍体分析;全部育龄期妇女均在月经干净第3-10天内行电子阴道镜下宫颈活检进行诊断对照。结果:本研究纳入患者141例,其中未见异倍体细胞者(N=0)14例(9.9%),见少量异倍体细胞者(0<N<3)78例(55.3%),见大量异倍体细胞者(N≥3)49例(34.8%);电子阴道镜引导下的活检阴性[炎症或是宫颈上皮内瘤变(CIN)Ⅰ]132例(93.6%),电子阴道镜引导下的活检阳性(≥CINⅡ)9例(6.4%)。DNA倍体分析对ASCUS患者中存在CINⅡ及以上病变诊断的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)分别为44.4%,65.9%,8.2%,94.6%。结论:DNA倍体分析可以及早发现有癌变倾向的病例,是一种分流ASCUS病人的良好方法。

Objective：To investigate the value of DNA ploidy analysis in the diagnosis of atypical squmous cell of undetermined significance（ASCUS）.Methods：From Aug 2012 to Sept 2013,141 cases of thin-prep cytology test（TCT）diagnosed ASCUS underwent DNA ploidy analysis.All the patients underwent colposcope directed biopsy during day 3to day 10 after menstruation.Results：Among 141 cases,14cases（9.9%）were not observed with DNA aneuploidy（N=0）,78cases（55.3%）were observed with a small amount of DNA aneuploidies（0〈N〈 3）,and 49cases（34.8%）were observed with large amounts of aneuploidies（N≥3）;132cases were confirmed negative by the colposcope,while 9cases（6.4%）were positive by coposcope directed biopsy.When DNA heteroploid more than or equal to three ploids were used to predict CIN Ⅱ or more severe cervical diseases,the sensitivity,specificity,positive predictive value and negative predictive value were 44.4%,65.9%,8.2%,and 94.6%,respectively.Conclusion：DNA ploidy analysis can help the early detection of cases with a cancerization tendency,and is a good way to diagnose ASCUS.