细胞DNA定量分析在宫颈病变筛查中的应用价值

发布时间：2018-04-15 10:25

本文选题：细胞DNA定量分析 + 液基细胞学　；参考：《中国医科大学学报》2017年11期

【摘要】：目的探讨细胞DNA定量分析技术在宫颈病变筛查中的应用价值。方法回顾性分析我院82 518例宫颈病变筛查结果,以活检病理结果为金标准,比较细胞DNA定量分析与液基细胞学检查(TCT)诊断宫颈病变的敏感度、特异度、阳性预测值及阴性预测值。应用受试者工作特征曲线评价2种诊断方法的准确性。结果细胞DNA定量分析、TCT及联合诊断筛查宫颈高度鳞状上皮内病变及宫颈癌的敏感度分别为77.37%、70.97%、90.24%,特异度分别为65.59%、70.42%、45.06%。细胞DNA定量分析的敏感度高于TCT,但特异度低于TCT,联合诊断筛查敏感度最高。TCT诊断为不典型鳞状上皮细胞(ASCUS)的患者中,细胞DNA定量分析阳性者42.71%活检病理结果为宫颈高度鳞状上皮内病变或宫颈癌,而阴性者仅为12.5%。细胞DNA定量分析筛查宫颈腺癌的漏诊率(39.13%)高于筛查宫颈鳞状细胞癌的漏诊率(15.11%),薄层细胞学涂片细胞数5 000个的漏诊率(57.83%)远高于细胞数5 000个的漏诊率(22.63%),联合TCT可以使筛查的漏诊率从20.19%降至13.38%。结论细胞DNA定量分析是一种有效的宫颈病变筛查手段,对宫颈高度鳞状上皮内病变及宫颈鳞状细胞癌的敏感性高于TCT,且可对ASCUS患者进行有效分流,其筛查效果略优于TCT。但细胞DNA定量分析特异度低于TCT,且对宫颈腺癌的筛查漏诊率高。细胞DNA定量分析与TCT联合应用可显著提高筛查的敏感性。
[Abstract]:Objective to evaluate the value of quantitative analysis of cellular DNA in screening cervical lesions.Methods the screening results of 82,518 cases of cervical lesions in our hospital were retrospectively analyzed. The sensitivity and specificity of DNA quantitative analysis and liquid-based cytology in the diagnosis of cervical lesions were compared.Positive predictive value and negative predictive value.The accuracy of the two diagnostic methods was evaluated by using the operating characteristic curve of the subjects.Results the sensitivity of cell DNA quantitative analysis and combined diagnosis in screening cervical squamous intraepithelial lesions and cervical carcinoma were 77.37 and 70.97, respectively. The specificity was 65.59 and 70.42 and 45.06, respectively.The sensitivity of cell DNA quantitative analysis was higher than that of TCT, but the specificity was lower than that of TCT.42.71% of the cases with positive DNA quantitative analysis showed cervical squamous intraepithelial lesions or cervical carcinoma, while those with negative results were only 12.5%.The missed diagnosis rate of quantitative analysis of cell DNA in screening cervical adenocarcinoma was higher than that of screening cervical squamous cell carcinoma (15.11%). The missed diagnosis rate of 5 000 TLC smears was much higher than that of 5 000 cells (22. 63%).In order to reduce the missed diagnosis rate from 20.19% to 13.38%.Conclusion quantitative analysis of cellular DNA is an effective screening method for cervical lesions. The sensitivity of Cellular DNA is higher than that of TCTs in high squamous intraepithelial lesions and squamous cell carcinoma of cervix, and it can effectively shunt the patients with ASCUS, and the screening effect is slightly better than that of TCT.Conclusion the quantitative analysis of cellular DNA is an effective screening method for cervical lesions.But the specificity of cell DNA quantitative analysis was lower than that of TCT, and the rate of missed diagnosis for cervical adenocarcinoma was high.The combination of cell DNA quantitative analysis and TCT can significantly improve the sensitivity of screening.
【作者单位】：中国医科大学附属盛京医院病理科;
【分类号】：R737.33

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