DNA定量分析用于宫颈癌及癌前病变的早期筛查探讨

[目的]探讨用DNA定量分析和常规细胞学相结合方法而诊断宫颈癌及癌前病变。[方法]对3266名妇女用宫颈刷取材,每例液基薄层制片2张,1张巴氏染色做常规细胞学检查,1张Feulgan DNA染色用全自动DNA倍体分析系统做DNA定量测定。常规细胞学和DNA倍体分析系统可疑的妇女在阴道镜下行宫颈组织学活检。[结果]3266例宫颈癌标本中,常规细胞学发现42例非典型鳞状上皮（ASCUS）,9例低级别鳞状上皮内病变（LSIL）及1例高级别鳞状上皮内病变（HSIL）。DNA倍体分析发现3个或3个以上〉5C细胞的35例。32例活检病例中有14例宫颈上皮内瘤变2（CIN2）或CIN2以上级别改变,这14例细胞标本中均可见DNA倍体异常,而常规细胞学发现1例正常,8例ASCUS,4例LSIL和1例HSIL。[结论]DNA倍体分析与常规细胞学相结合方法可提高宫颈癌及癌前病变的阳性率。

Screening for Early Cervical Cancer and Precancerous Cervical Lesions by DNA Ploid Analysis

[Purpose] To explore the diagnosis for cervical cancer and precancerous cervical lesions by DNA ploid analysis combined with cytology. [Methods] A total of 3266 cervical samples were obtained by cervix brush. Cell monolayers were prepared by a liquid based sample preparation. Two slides were prepared from each case: one slide was stained by Papanicolaou stain for conventional cytology examination, while the other slide was stained by Feulgen-Thionin method to measure relative amount of DNA in cell nuclei using an automated DNA imaging cytometer. Women suspected by cytology and DNA ploid underwent a colposcope examination and biopsy. [Results] Forty-two cases proved atypical squamous cells of undermined significance (ASCUS) by cytology; 9 cases, low-grade squamous intraepithelial lesion (LSIL); and 1 case, high-grade squamous intraepithelial lesion(HISL) were found, while DNA ploid analysis found 35 cases having 3 or more cells with DNA greater than 5C in a total of 3266 women. Fourteen cases with cervical intraepithelial neoplasia 2(CIN2 or over) out of 32 biopsies were diagnosed as 1 case, normal; 8 cases, ASCUS; 4 cases, LSIL and 1 case, HSIL by cytology. However all 14 cases were determined aneuploid cells by a DNA image cytometry. [Conclusion] Combination of DNA ploid analysis and cytology can increase positive rate of detection for cervical cancer and precancerous cervical lesions.