流式细胞术联合阴道镜活检在宫颈癌和癌前病变筛查中的意义

目的 探讨流式细胞术联合阴道镜活检在宫颈癌和癌前病变筛查中的应用价值。方法 选取2014年6月—2016年6月在我院就诊进行宫颈癌检查并有活检结果的705例病例进行研究,并用流式细胞术对此705例患者进行DNA含量分析,以DNA指数(DNA index,DI)、增殖指数(Proliferative index,PI)值作为DNA含量分析的参数。结果 阴道镜拟诊结果显示CINⅠ、CINⅡ、CINⅢ/CIS、宫颈癌的检出率分别为62.2%、78.0%、100%、100%;流式细胞仪检测DNA倍性在CINⅡ及其以上级别病变(CINⅡ、CINⅢ或CIS和宫颈癌病变)的敏感性为87.7%(213/243),特异性为90.2%(417/462)。随着宫颈组织病变程度的加重,DI、PI值均呈上升趋势,且各组之间进行比较差异均具有统计学意义(P＜0.05)。结论 流式细胞术联合阴道镜活检可提高宫颈癌和癌前病变诊断率、准确性和敏感性,是适合筛查宫颈癌和癌前病变的工具之一,值得临床推广和应用。

The clinical application value of flow-cytometry combined with colposcope ultra high frequency electric knife for diagnosis of uterine cervix carcinoma and cervical intraepithelial neoplasia

Objective To explore the clinical application value of flow -cytometry combined with colpo-scope ultra high frequency electric knife for diagnosis of uterine cervix carcinoma ( UCC) and cervical intraepitheli-al neoplasia(CIN).Methods A total of 705 cases was included in this study who were screened from April 2014 to April 2016 and accepted colposcopy biopsy .DNA flow cytometry was performed to determine DNA index ( DI) and proliferative index ( PI) .Results Colposcopy diagnosis results showed that the detection rate of CINⅠ,CINⅡ,CINⅢ/CIS and UCC were 62.2%,78.0%,62.2% and 78.0% respectively.The sensitivity and specificity were 87.7%(213/243)and 90.2%(417/462)for DNA ploidy test using flow-cytometry.DI and PI of CINⅠ, CINⅡ,CINⅢ/CIS and UCC increased gradually with significant differences (P<0.05).Conclusion Flow-cytometry combined with colposcopy biopsy may be a useful tool for cervical cancer screening in developing coun -tries and has a competitive sensitivity and specificity ,which is worthy of popularization and application .