未明确诊断意义的不典型子宫颈鳞状细胞伴DNA倍体异常的临床意义

目的通过宫颈细胞学和DNA倍体分析,探讨未明确诊断意义的不典型鳞状细胞（ASCUS）伴有DNA倍体异常的临床意义。方法选择2010年7月至2011年7月湖北省宜昌市妇幼保健院在夷陵地区进行宫颈癌筛查的635例农村妇女的宫颈细胞学、病理学及DNA倍体分析资料进行分析。将宫颈脱落细胞制成两张玻片,一张巴氏染色行TBS诊断,另一张Feulgen染色行DNA倍体分析。结果在635例宫颈细胞学标本中,正常细胞学418例,ASCUS 145例,不除外高度鳞状上皮内病变（ASC-H）17例,低度鳞状上皮内病变29例,高度鳞状上皮病变26例,其中伴DNA倍体异常（非整倍体细胞）者所占比例分别为2.6%（11/418）、22.8%（33/145）、76.5%（13/17）、89.7%（26/29）和96.2%（25/26）。在阴道镜下活检的145例ASCUS患者中,伴DNA倍体异常者33例,其中10例（30.3%）为CIN2及以上病变;DNA倍体正常者112例,其中9例（8.0%）为CIN2;两者比较,差异有统计学意义（P〈0.01）。17例ASC-H患者中,13例（76.5%）DNA倍体异常者均检出CIN2及以上病变;4例DNA倍体正常者检出1例CIN2,两者比较,差异有统计学意义（P〈0.01）。结论 ASCUS、ASC-H伴有DNA倍体异常患者检出CIN2及以上病变风险增高。

The clinical significance of ASCUS cases with abnormal DNA ploidy

Objective To investigate the significance of ASCUS cases with DNA aneuploidy.Methods 635 women were underwent cervical cancer screening from July,2010to July,2011.For each woman two slides were made by a cytospin.One slide was stained by Pap solution for TBS diagnosis,the other one was stained by Feulgen for DNA ploidy analysis.635cases with abnormal finding underwent cervical biopsies.Results 145ASCUS,17 ASC-H,29LSIL and 26HSIL were found by TBS diagnosis.More than 5caneuploid cells were determined in 22.8%of ASCUS,76.5%of ASC-H,89.7% of LSIL and 96.2% of HSIL cases.84cases of CIN2,CIN3or cancers were found in 635cervical biopsies.30.3% ASCUS and 76.5% ASC-H with aneuploid cells were comfirmed as CIN2,CIN3or cancer,while 8.0% ASCUS and 25.0% ASC-H with diploid cells were diagnosed as CIN2,CIN3 or cancer.Conclusion ASCUS and ASC-H with aneuploid cells has high risk for CIN2,CIN3or cancers.