DNA倍体分析和HPV检测在宫颈ASCUS诊断中的意义

Significance of DNA ploidy analysis and HPV testing in diagnosis of ASCUS

目的对宫颈液基细胞检查考虑为非典型鳞状上皮细胞(ASCUS)而活检诊断宫颈高级别鳞状上皮内上皮病变(HSIL)的病例进行联合检测DNA倍体和HR-HPV,研究DNA倍体分析和HR-HPV检测对ASCUS病例诊断和临床处理的意义。方法选取1 087例经活检确诊的ASCUS病例分别进行DNA倍体分析和HR-HPV检测,出现非整倍体、多倍体以及细胞DNA含量>9c的病例均视为倍体异常。结果在液基细胞学诊断ASCUS而活检诊断为HSIL的病例中89.5%(68/76)的病例检测出DNA倍体异常,HR-HPV感染为84.2%(64/76)。HR-HPV感染和/或DNA倍体异常与宫颈HSIL之间差异有统计学意义(Ρ=0.001,0.001和0.001)。细胞核DNA含量>9c与宫颈HSIL之间差异有统计学意义(Ρ=.001)。结论宫颈液基细胞学标本出现HR-HPV阳性和DNA倍体异常,特别是出现细胞核DNA含量>9c,预示很可能存在宫颈HSIL或者具有进展为宫颈HSIL的可能,联合检测HR-HPV和DNA倍体改变有助于宫颈HSIL早期筛查。

Objective To explore the value of HR- HPV and DNA ploidy in diagnose cervical highgrade squamousintraepithelial lesion（ HSIL） on atypical squamous cells,（ASCUS） smears.Methods The 1 087 ASCUS smears were selectedand the DNA ploidy and positive HR- HPV were detected by liquid- based cytometry and/or a testing was analyzed. Theaneuploidy, multiploidy, or in the presence of cells with a DNA content ≥9c were regarded as abnormal ploidy. Results Suspect DNA ploidy were detected in 89.5%（68/76）women with HSILas detected by biopsy test and with ASCUS tested byliquid-based cytometry, 84.2%（64/76）women were HR-HPV-positive. The HR-HPV test positive or a suspect DNA profileor both were significantly correlated with HSIL（Ρ=0.001,0.001 and 0.001, respectively）. The DNA content 〉9c was significantcorrelated with HSIL（Ρ=.001）. Conclusions HR-HPV testing positive and the ploidy profile,especially the presence of9c-exceeding cells may indicate an underlying concurrent cervical HSIL or the progression toward a HSIL.The combinationdetection of HR-HPV and abnormalities of DNA ploidy is useful for early diagnosis of HSIL.