细胞DNA定量分析技术在宫颈癌筛查中的应用

The application of DNA- image cytometry in cervical cancer screening

目的:比较和评估两种宫颈癌筛查方法的应用价值。方法:选取2010年1月至2013年2月到漳浦县医院进行宫颈癌检查的病例14119例。均为宫颈刷取材,液基方法同时制两张片,一张进行巴氏染色,用于常规细胞学TBS诊断。另一张经Feulgen染色,用于细胞DNA定量分析检测。临床活检取材均在阴道镜指导下进行。结果:共建议活检671例。用于回顾性研究的388例有活检结果。其中有宫颈癌5例,CINⅢ/原位癌38例,44例CINⅡ及137例CINⅠ,其余164例为慢性宫颈炎。以活检结果≥CINⅡ作为宫颈癌前病变的阳性标准,采用细胞DNA定量分析检测的敏感性分别为70.11%与97.7%,而常规细胞学检测的敏感性分别为45.98%与58.62%。同一个标本同时采用两种方法联合检测,敏感性可提高到99.89%。结论:细胞DNA定量分析技术可作为宫颈癌及癌前病变检测的辅助手段。

Objective： To evaluate the application value of DNA image cytometry （ DNA - ICM ） in the screening of cervical carcinoma. Methods： All 14119 women screened from 2010 to 2013 were reviewed. The cytology samples were taken by cervix brush and prepared to 2 slides for each case ： one was Pap - stained and read by cytologist ac- cording to the TBS criteria,the other was Feulgen -stained, scanned and analyzed by DNA -ICM. The biopsies were conducted with the guidance of eolposcopy. Results：In the retrospective study,388 in 671 women recommended were reported with biopsy results which included 5 cases with cervical cancer, 38 CINⅢ/CIS eases,44 CIN Ⅱ and 137 CIN I . The sensitivity of DNA - ICM were 70.11% and 97.7% ,while the TBS report of cervical cytology test were 45.98% and 58.62%. The sensitivity increased to 99.89% when combining the both. Conclusion ： DNA - ICM is a useful adjunct for cervical cancer screening combined with cervical cytology test.