细胞DNA定量分析技术在宫颈癌及癌前病变早期筛查中的应用价值

THE VALUE OF CELL DNA QUANTITATIVE ANALYSIS IN THE EARLY SCREENING OF CERVICAL CANCER AND PRE-CANCERATION

目的分析细胞DNA定量分析技术对宫颈癌及癌前病变进行早期筛查的临床意义。方法选取2012年11月~2014年11月间收治的80例宫颈病变患者作为临床研究对象,均实施宫颈刷取材检测,制作出两张宫颈液基细胞学制片,一张采用硫堇-Feulgen进行染色,然后通过细胞DNA定量分析系统定量检测其细胞核中的DNA含量;一张采用巴氏染色后进行常规细胞学检测。若检测的结果为阳性则进行阴道镜或于阴道镜指导下取检,然后通过活检的结果对两种方法的准确性进行比较分析。结果通过进行细胞DNA定量分析发现,检测所得宫颈阳性病变70例;而通过进行常规细胞学检验发现,检查所得宫颈阳性病变27例。根据组织学诊断宫颈癌病变的相关标准对两种检测方法进行评价可得,细胞DNA定量分析的相对敏感性（Se）为94.8%,相对特异性（Sp）为99.6%。而常规细胞学检验的相对敏感性（Se）为38.8%,相对特异性（Sp）为99.8%。两种检测技术的相对敏感性比较,差异均有统计学意义（p〈0.05）。结论细胞DNA定量分析技术在宫颈癌及癌前病变的早期筛查中具有非常高的临床价值,值得在临床上进一步推广。

Objective To evaluate the application of DNA image cytometry in screening cervical intraepithelial neoplasia and cervical cancer. Methods 80 patients with cervical intraepithelial neoplasia admitted during November 2012 and November 2014 were involved in this study. The samples from all the patients were taken by cervix brushes and prepared for 2 slides： one for liquid- based cytology staining,read by cytologist,and the other for Thionin- Feulgen staining,tested by DNA image cytometry. The biopsy was performed with direction of colposcopy if one test was positive to verify the sensitivity and specificity of the two methods of staining. Results 70 cases were positive by DNA image cytometry and 27 ones were positive by liquid- based cytology. There was statistically significant difference in the sensitivity between the DNA image cytometry and the liquid- based cytology（ 94. 8% vs.38. 8%; p 〈 0. 05）,but no difference in the specificity between them（ 99. 6% vs. 99. 8%）. Conclusion Besides its good specificity,DNA image cytometry is more sensitive in screening cervical intraepithelial neoplasia and cervical cancer.