病变鳞状上皮细胞DNA倍体分析对宫颈上皮内瘤变的诊断和预后分析

Diagnosis and prognosis of cervical intraepithelial neoplasia by DNA ploidy analysis of diseased squamous epithelial cells

目的 探讨病变鳞状上皮细胞DNA倍体分析对宫颈上皮内瘤变(CIN)的诊断和预后的价值分析。方法 选取2019年1月至2022年1月西安市第三医院就诊的115例CIN患者作为研究对象,其中低级别鳞状上皮内病变患者32例,高级别鳞状上皮内病变患者83例。采用Blue Feulgen检测试剂盒检测患者DNA倍体,并使用DNA图像细胞术分析DNA倍体。结果 低级别鳞状上皮内病变患者中有17例(53.1%)出现异倍体,而高级别鳞状上皮内病变患者中有68例(81.9%)为异倍体;高级别鳞状上皮内病变患者中DNA异倍体的出现率更高(P<0.05)。DNA倍体与CIN分级关系分析发现,CINⅠ级DNA异倍体阳性率为54.5%,CINⅡ级DNA异倍体阳性率为69.2%,CINⅢ级DNA异倍体阳性率高达95.6%。DNA倍体细胞数预测CIN的受试者工作特征(ROC)曲线显示,曲线下面积为0.913。随访2年发现,CINⅡ级和CINⅢ级患者治疗后有17例复发,其中16例(94.1%)是异倍体阳性。结论 随着CIN分级的增加,DNA倍体异常情况发病率越高,DNA倍体细胞数变化可很好地预测CIN,且DNA倍体异常与CIN患者预后也具有一定的相关性。

Objective To explore the diagnostic and prognostic value of DNA ploidy analysis of diseased squamous epithelial cells in cervical intraepithelial neoplasia(CIN).Methods A total of 115 patients who came to Xi'an Third Hospital from January 2019 to January 2022 were selected as research subjects,including 32 patients with low-grade squamous intraepithelial lesions and 83 patients with high-grade squamous intraepithelial lesions.DNA ploidy was detected with Blue Feulgen detection kit and analyzed by DNA imaging cytography.Results It was found that 17 cases(53.1%)of patients with low-grade squamous intraepithelial lesions were heteroploidy,while 68 cases(81.9%)of patients with high-grade squamous intraepithelial lesions were heteroploidy,and the occurrence rate of DNA heteroploidy was higher in high-grade squamous intraepithelial lesions(P<0.05).Analysis of the relationship between DNA ploidy and CIN grading showed that the positive rate of DNA heteroploidy in CINⅠwas 54.5%,that in CINⅡwas 69.2%,and that in CINⅢwas 95.6%.The receiver operating characteristic(ROC)curve of DNA ploidy number predicting CIN showed that area under curve is 0.913.In the following two years of follow-up,it was found that 17 patients with CINⅡand CINⅢrelapsed after treatment,among which 16(94.1%)were heteroploidy positive.Conclusions With the increase of CIN grade,the incidence of abnormal DNA ploidy is higher,and the change of DNA ploidy cell number can well predict CIN,and abnormal DNA ploidy is also correlated with the prognosis of CIN patients.