DNA倍体定量分析、TCT及HR-HPV检测在宫颈上皮病变中的应用评估

Evaluation of DNA Ploidy Quantitative Analysis,TCT and HR-HPV Detection in Cervical Intraepithelial lesion

目的探讨DNA倍体定量分析以及液基薄层细胞学检测(TCT)、高危型人乳头瘤病毒(HR-HPV)检测在宫颈上皮病变诊断中的应用价值。方法对608例具有宫颈活检病理诊断结果患者回顾分析DNA倍体定量分析、TCT和HR-HPV检测结果,分别计算DNA倍体定量分析以及联合TCT、HR-HPV检测在低级别鳞状上皮内病变(LSIL)及以上病变诊断的灵敏度、特异度,并进行比较。结果DNA倍体定量分析、TCT和HR-HPV检测对LSIL以上宫颈病变诊断灵敏度分别是85.8%、73.8%、83.7%,特异度分别是74.3%、61.2%、57.3%,DNA倍体定量分析灵敏度比TCT高,有统计学意义(P<0.05),与HR-HPV相比,差异无统计学意义(P>0.05),特异度比TCT、HR-HPV检测都高,差异有统计学意义(P<0.05),DNA倍体定量分析+TCT、DNA倍体分析+HR-HPV检测、TCT+HR-HPV检测、DNA倍体定量分析+TCT+HR-HPV检测在诊断LSIL以上宫颈病变的灵敏度分别是90.5%、91.3%、87.7%、92.4%,特异度分别是62.8%、63.4%、60.1%、65.6%。DNA倍体分析联合TCT或HR-HPV检测在灵敏度上与DNA倍体分析+TCT+HR-HPV联合检测差异无统计学意义(P>0.05),特异度上与DNA倍体分析+TCT+HR-HPV联合检测差异无统计学意义(P>0.05)。结论DNA倍体定量分析单独或联合TCT、HR-HPV检测在宫颈病变LSIL及以上病变的筛查中具有较高的诊断价值。

Objective To investigate application value of DNA ploidy quantitative analysis combined with thinprep cytologic test(TCT),high risk type of human papillomavirus(HR-HPV)detection in cervical intraepithelial lesions.Methods The results of DNA ploidy quantitative analysis,TCT and HR-HPV were retrospectively analyzed in 608 patients with cervical biopsy pathological diagnosis.The sensitivity and specificity of DNA ploidy quantitative analysis and combined TCT and HR-HPV in the diagnosis of low-grade squamous intraepithelial lesions(LSIL)and above were calculated and compared.Results Diagnostic sensitivity of DNA ploidy quantitative analysis,TCT and HR-HPV detection on LSIL and the above lesions was 85.8%,73.8%and 83.7%respectively.The diagnostic specificity was 74.3%,61.2%and 57.3%respectively.The sensitivity of DNA ploidy quantitative analysis was higher than TCT,with significant difference(P<0.05).Compared with HR-HPV detection,the difference was not statistically significant(P>0.05).Compared with TCT and HPV detection,diagnostic specificity of DNA ploidy quantitative analysis was higher,with significant difference(P<0.05).The diagnostic sensitivity of DNA ploidy quantitative analysis combined with TCT,DNA ploidy quantitative analysis combined with HR-HPV detection,TCT combined with HR-HPV detection,DNA ploidy quantitative analysis combined with TCT and HR-HPV detection on LSIL and the above lesions was 90.5%,91.3%,87.7%and 92.4%respectively.The diagnostic specificity was 62.8%,63.4%,60.1%and 65.6%respectively.The diagnostic sensitivity of DNA ploidy quantitative analysis combined with TCT or HR-HPV detection was no significant difference with DNA ploidy quantitative analysis combined with TCT and HR-HPV detection(P>0.05).The diagnostic specificity of DNA ploidy quantitative analysis combined with TCT or HR-HPV detection was no significant difference with DNA ploidy quantitative analysis combined with TCT and HR-HPV detection(P>0.05).Conclusion DNA ploidy quantitative analysis only or combined with TCT,HR-HPV detection in Cervical intraepithelial lesion LSIL and above lesions had a higher diagnostic value.