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目的:探讨DNA倍体分析在宫颈病变筛查中的作用。方法:选取2012年在无锡妇幼保健院同时行DNA倍体分析及液基薄层制片检查(TCT)的1 179例进行数据分析,其中122例进行病理活检。结果:在TCT为正常、炎性改变、非典型鳞状上皮(ASCUS)、低度病变(LSIL)、高度病变(HSIL)及鳞状细胞癌(SCC)中,对应的DNA倍体阳性率分别为3.7%、25.5%、81.0%、91.3%、100%。以病理活检结果为金标准,DNA倍体分析ROC曲线下面积(0.879)大于TCT ROC曲线下面积(0.799),DNA倍体分析及TCT的敏感性分别为89.4%和68.4%,特异性分别为76.2%和85.7%,阳性预测值分别为63.0%和68.4%,阴性预测值分别为94.1%和85.7%,其中敏感性差异有统计学意义(P<0.05)。对于少量DNA倍体异常细胞,联合TCT结果可以提高诊断的准确性。结论 :DNA倍体分析是一种有效的宫颈病变筛查方法。
Objective: To explore the role of DNA ploidy in screening cervical lesions. Methods: A total of 1 179 cases of simultaneous DNA ploidy analysis and liquid-based lamellar examination (TCT) performed in Wuxi Maternal and Child Health Hospital in 2012 were selected for data analysis. Of 122 cases, pathological biopsy was performed. Results: The positive rates of DNA ploidy in normal, inflammatory changes, atypical squamous epithelium (ASCUS), low grade lesion (LSIL), high grade lesion (HSIL) and squamous cell carcinoma (SCC) 3.7%, 25.5%, 81.0%, 91.3%, 100%. The results of pathological biopsy showed that the area under ROC curve (0.879) was greater than the area under TCT ROC curve (0.799), the DNA ploidy analysis and TCT sensitivity were 89.4% and 68.4%, respectively, and the specificity was 76.2% and 85.7% respectively. The positive predictive value was 63.0% and 68.4% respectively, and the negative predictive value was 94.1% and 85.7% respectively. The sensitivity was statistically significant (P <0.05). For a small amount of DNA ploidy abnormal cells, combined TCT results can improve the diagnostic accuracy. Conclusion: DNA ploidy analysis is an effective screening method for cervical lesions.