DNA倍体分析在宫颈上皮内瘤变病情监测中的应用价值

发布时间：2018-03-03 17:41

本文选题：DNA倍体分析　切入点：宫颈上皮内瘤变　出处：《首都医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨DNA倍体分析在宫颈上皮内瘤变病情监测中的应用价值。方法:选择首都医科大学附属北京友谊医院妇产科2015年4月至2015年12月经阴道镜活检病理诊断为宫颈上皮内瘤变的患者84例及经阴道镜活检病理诊断为宫颈慢性炎症的患者30例,治疗后6个月、12个月进行随访观察。对纳入研究的患者治疗前、治疗后6个月、治疗后12个月复查时均行宫颈HR-HPV、阴道镜活检及DNA倍体分析检测。监测治疗前后宫颈病变的残留或复发,从而为指导临床治疗,探索更有效的宫颈病变治疗后随诊方案。结果:1、随着宫颈病变程度的增加,HR-HPV阳性率及DNA倍体分析检测阳性率也随之增加。DNA异倍体细胞数随宫颈病变程度升高呈正相关递增关系。2、手术治疗后6个月、12个月复查时宫颈病变程度、HR-HPV阳性率、DNA倍体分析阳性率较前均有显著降低。3、治疗前84例CIN患者中,有78例HR-HPV感染病例,其中45例伴有DNA倍体分析阳性。治疗后6个月复查有10例HR-HPV持续感染病例,其中7例伴有DNA倍体分析阳性。治疗后12个月复查有5例HR-HPV持续感染病例,其中4例伴有DNA倍体分析阳性。4、合并HR-HPV感染的ASCUS患者,DNA倍体阳性预测CIN II以上宫颈病变的灵敏度为96.43%。结论:1、HR-HPV感染率、DNA倍体分析阳性率及DNA异倍体细胞数随宫颈病变级别升高呈上升趋势。2、手术治疗能有效降低宫颈病变程度、降低HR-HPV阳性率及DNA倍体检测阳性率。3、合并HR-HPV持续感染的CIN患者中,同时行DNA倍体分析检测可提高诊断的敏感度,降低漏诊率,可辅助预测宫颈病变的进展情况,较好的监测宫颈病变的预后情况。4、DNA倍体分析在HR-HPV感染的ASCUS患者的分流诊治中有较高的临床应用价值,有助于早发现和早治疗。
[Abstract]:Objective: to evaluate the value of DNA ploidy analysis in monitoring cervical intraepithelial neoplasia. Methods: the pathological diagnosis of gynecology and obstetrics department of Beijing Friendship Hospital affiliated to Capital Medical University from April 2015 to 2015 was selected. 84 cases of cervical intraepithelial neoplasia and 30 cases of chronic cervix inflammation diagnosed by colposcopy biopsy were studied. 6 months and 12 months after treatment, the patients who were included in the study were followed up for 6 months before and 6 months after treatment. HR-HPVP, colposcopy biopsy and DNA ploidy analysis were performed 12 months after treatment. The residual or recurrence of cervical lesions was monitored before and after treatment, so as to guide clinical treatment. Results the positive rate of HR-HPV and the positive rate of DNA ploidy analysis also increased with the increase of cervical lesion degree. The number of DNA aneuploidy cells increased positively with the degree of cervical lesion. The positive rate of HR-HPV and the positive rate of DNA ploidy in HR-HPV were significantly lower than those before operation. The positive rate of HR-HPV and DNA ploidy in 84 patients with CIN before treatment were significantly lower than those before treatment. There were 78 cases of HR-HPV infection, of which 45 cases were positive for DNA ploidy analysis, 10 cases were HR-HPV persistent infection after 6 months of treatment, 7 cases were positive for DNA ploidy analysis, and 5 cases were HR-HPV persistent infection at 12 months after treatment. Among them, 4 cases with DNA ploidy analysis were positive. The sensitivity of ASCUS patients with HR-HPV infection in predicting cervical lesions above CIN II was 96.43. Conclusion the positive rate of DNA ploidy analysis and the number of DNA aneuploidy cells in the patients with HR-HPV infection are 96.433.Conclusion the positive rate of ASCUS ploidy analysis and the number of DNA aneuploidy cells are correlated with cervical diseases. The increase of grade of change shows an upward trend. The surgical treatment can effectively reduce the degree of cervical lesions. To reduce the positive rate of HR-HPV and the positive rate of DNA ploidy. In CIN patients with persistent infection of HR-HPV, DNA ploidy analysis at the same time can improve the sensitivity of diagnosis, reduce the rate of missed diagnosis, and can help to predict the progress of cervical lesions. Better monitoring the prognosis of cervical lesions .4DNA ploidy analysis has a high clinical value in the diagnosis and treatment of ASCUS patients with HR-HPV infection, which is helpful for early detection and treatment.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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