TCT、HPV检测及DNA倍体定量分析筛查宫颈癌的结果研究

Screening results of cervical cancer by TCT,HPV and DNA ploidy quantitative analysis

目的观察液基细胞学检测(TCT)、人乳头瘤病毒(HPV)检测及DNA倍体定量分析(DNA-ICM)应用在宫颈癌筛查中的应用价值。方法选取260例宫颈癌筛查和阴道镜活检患者,均接受TCT、HPV、DNA-ICM检测,比较三种差异化筛查方法的宫颈癌筛查结果。结果260例受检者的活检组织中,病理诊断为阴性(正常/慢性宫颈炎)患者86例(33.08%);诊断为阳性患者174例(66.92%),其中宫颈上皮内瘤变(CIN)Ⅰ、Ⅱ、Ⅲ级分别为48例、32例、28例,原位癌35例,宫颈浸润癌31例。TCT检查阳性患者126例,HPV检查阳性患者144例,DNA-ICM检查阳性患者151例。DNA-ICM检测的敏感度高出TCT检测14.37%(P<0.05),HPV检测敏感度高出TCT检测10.35%(P<0.05);DNA-ICM检测的特异度高于TCT检测19.77%,高于HPV检测10.46%(P<0.05);DNA-ICM检测准确率高于TCT检测16.15%(P<0.05)。结论DNA-ICM检测具有较高敏感度、特异度、准确率,可联合TCT或HPV检测降低宫颈癌发病率、死亡率。

Objective To observe the application value of liquid based cytology(TCT),human papillomavirus(HPV)and DNA ploidy quantitative analysis(DNA-ICM)in cervical cancer screening.Methods 260 patients with cervical cancer screening and colposcopic biopsy were selected and tested by TCT,HPV and DNA-ICM,and the results of cervical cancer screening by three different screening methods were compared.Results Of the 260 biopsies,86(33.08%)were pathologically negative(normal/chronic cervicitis).174 patients(66.92%)were diagnosed as positive,including 48 cases of CIN I,32 cases of II,28 cases of II,35 cases of carcinoma in situ,and 31 cases of cervical invasive carcinoma.There were 126 patients positive for TCT,144 positive for HPV,and 151 positive for DNA-ICM.The sensitivity of DNA-ICM was 14.37%higher than that of TCT(P<0.05),and the sensitivity of HPV was 10.35%higher than that of TCT(P<0.05).The specificity of DNA-ICM was 19.77%higher than TCT and 10.46%higher than HPV(P<0.05).The accuracy of DNA-ICM was 16.15%higher than that of TCT(P<0.05).Conclusion DNA-ICM detection has high sensitivity,specificity and accuracy,and can reduce the incidence and mortality of cervical cancer in combination with TCT or HPV detection.