DNA定量分析联合阴道镜在诊断宫颈癌及高级别宫颈上皮内瘤变中的价值

目的:探讨宫颈细胞DNA定量分析法联合阴道镜在宫颈癌及高级别宫颈上皮内瘤变(CIN)诊断中的价值。方法:对4 577名妇女的宫颈细胞采用DNA定量分析系统和常规细胞学进行检查,常规细胞学诊断低级别鳞状上皮内瘤变(LSIL)及以上级别或DNA定量分析异常者在阴道镜下行宫颈活组织病理检查。结果:50名妇女做了病理活检,病理诊断宫颈癌及CIN 2以上病变共27例,其中DNA定量分析方法异常25例(92.6%),常规细胞学异常6例(22.2%),阴道镜异常22例(81.5%),三者间差异有统计学意义(P<0.005)。DNA定量分析及阴道镜检查筛查子宫颈癌及高级别宫颈上皮内瘤变(≥CIN2)的敏感度、特异度均高于常规细胞学。结论:DNA定量分析方法联合阴道镜在早期诊断宫颈癌及高级别宫颈上皮内瘤变方面有更高的敏感性,适合在基层单位大力推广。

Value of DNA quantitative analysis combined with colposcopy for diagnosis of cervical cancer and high-grade cervical intraepithelial neoplasia

Objective: To explore the value of DNA quantitative analysis of cervical cells combined with colposcopy for diagnosis of cervical cancer and high-grade cervical intraepithelial neoplasia(CIN). Methods: The cervical cells of 4 577 women were examined by DNA quantitative analysis system and routine cytologic test,the women diagnosed as low-grade squamous intraepithelial lesion(LSIL) and lesions above by routine cytologic test and the women with abnormal results of DNA quantitative analysis underwent cervical biopsy under colposcope and pathological examination. Results: Fifty women underwent pathological biopsy,and 27 women were diagnosed as cervical cancer and ≥CIN Ⅱ lesions,25 women(92.6%) were found with abnormal results of DNA quantitative analysis,6 women(22.2%) were found with abnormal results of routine cytologic test,22 women(81.5%) were found with abnormal results of colposcopy,there was statistically significant difference among the three rates(P<0.005).The sensitivities and specificities of DNA quantitative analysis and colposcopy for screening of cervical cancer and ≥CIN Ⅱ lesions were superior to those of routine cytologic test. Conclusion: DNA quantitative analysis combined with colposcopy has higher sensitivity for early diagnosis of cervical cancer and high-grade CIN,which is suitable for popularization in primary medical institutions.