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目的探讨DNA倍体分析和液基细胞学在宫颈病变早期筛查中的应用。方法以阴道镜下活检为金标准,分析2014年1-6月在湖北省妇幼保健院妇科同时行DNA倍体分析和液基细胞学检查的297例患者检测结果。结果297例患者中198例DNA阴性:其中宫颈液基细胞学为NILM为187例,ASCUS为9例,LSIL为2例。而阴道镜活检结果为慢性宫颈炎182例,CINⅠ11例,CINⅢ3例,宫颈癌2例;DNA倍体异常99例:其中宫颈液基细胞学为NILM为20例,ASCUS为45例,LSIL为23例,HSIL为11例。而阴道镜活检结果为慢性宫颈炎37例,CINⅠ25例,CINⅡ9例,CINⅢ18例,宫颈癌10例。DNA倍体分析和液基细胞学预测CINⅡ及以上病理改变,其敏感性、阴性预测值分别为88.10%和78.57%、97.47%和95.65%。两种方法联合检测预测CINⅡ及以上病理改变,其敏感性、阴性预测值分别为95.24%、98.93%。结论 DNA倍体分析可用于宫颈病变的早期筛查,联合液基细胞学敏感性高,可降低漏诊率。
Objective To investigate the application of DNA ploidy analysis and liquid-based cytology in the early screening of cervical lesions. Methods According to colposcopy biopsy as the gold standard, the results of 297 patients who underwent concurrent gynecological examination of DNA ploidy and liquid-based cytology from January to June 2014 in Hubei MCH were analyzed. Results Among the 297 patients, 198 cases were DNA negative: 187 cases were cervical liquid-based cytology with NILM, 9 cases with ASCUS and 2 cases with LSIL. Colposcopy biopsy results of chronic cervicitis in 182 cases, CINⅠ11cases, CINⅢcases, cervical cancer in 2 cases; DNA ploidy abnormalities in 99 cases: cervical liquid-based cytology NILM 20 cases, ASCUS 45 cases, LSIL 23 For example, HSIL is 11 cases. The results of colposcopy biopsy for chronic cervicitis in 37 cases, CIN I25 cases, CINⅡ9 cases, CINⅢ18 cases, cervical cancer in 10 cases. DNA ploidy analysis and liquid-based cytology predict CINⅡ and above pathological changes, the sensitivity and negative predictive value were 88.10% and 78.57%, 97.47% and 95.65% respectively. The combined detection of the two methods predicted the pathological changes of CINⅡ and above, with the sensitivity and the negative predictive value of 95.24% and 98.93%, respectively. Conclusion DNA ploidy analysis can be used for early screening of cervical lesions, combined with liquid-based cytology, high sensitivity, can reduce the rate of misdiagnosis.