论文部分内容阅读
目的探讨宫颈液基细胞学和DNA定量细胞学在宫颈癌前病变及宫颈癌诊断中的应用价值。方法对2156例患者进行宫颈液基细胞学和DNA定量细胞学检查,对其中221例液基细胞学和(或)DNA定量分析阳性者行宫颈活检,以活检结果为金标准,比较两种方法的检测结果及DNA定量细胞学对ASCUS患者的分流作用。结果 1.液基细胞学以≥ASCUS,DNA定量细胞学以可见DNA倍体异常细胞作为活检标准及联合两种方法检测,活检结果以CINⅠ及以上病理改变作为阳性结果,其敏感度、特异度、阳性预测值、阴性预测值分别为69.77%、77.52%和89.15%,38.04%、48.91%和84.09%,61.22%、63.69%和86.47%,47.30%、60.81%和84.09%。2.TCT与DNA定量细胞学检测方法灵敏度及特异度对比,均无统计学意义(P>0.05);TCT联合应用DNA定量细胞学与单独应用TCT检测方法灵敏度及特异度对比,均有统计学意义(P<0.01);TCT联合应用DNA定量细胞学与单独应用DNA定量细胞学检测方法灵敏度对比,无统计学意义(P>0.05),特异度对比,有统计学意义(P<0.01)。3.ASCUS患者宫颈病变的检出率为56.25%。ASCUS患者以DNA定量细胞学作为分流方法:阳性组检出率为74.00%,阴性组检出率为26.67%,两组检出率对比,有高度统计学差异(P<0.01);DNA定量细胞学阳性组与ASCUS患者未分流前检出率对比,有统计学意义(P<0.05)。结论 DNA定量分析方法与液基薄层细胞学联合筛查,可提高宫颈癌前病变及宫颈癌筛查的敏感度和特异度,对于细胞学检测为ASCUS的人群有分流作用。
Objective To investigate the value of cervical liquid-based cytology and DNA quantitative cytology in the diagnosis of cervical precancerous lesions and cervical cancer. Methods Cervical liquid cytology and DNA quantitative cytology were performed in 2156 patients. Totally 221 cervical cytology and / or DNA positive were biopsied by cervical biopsy. The biopsy result was the gold standard. Two methods were compared The detection results and DNA quantitative cytology in patients with ASCUS shunt. Results 1. Liquid-based cytology with ≥ ASCUS, DNA quantitative cytology to detect DNA ploidy abnormal cells as a biopsy standard and a combination of two methods, biopsy results with CIN Ⅰ and above pathological changes as a positive result, the sensitivity, specificity The positive predictive value and negative predictive value were 69.77%, 77.52% and 89.15%, 38.04%, 48.91% and 84.09%, 61.22%, 63.69% and 86.47%, 47.30%, 60.81% and 84.09%, respectively. Sensitivity and specificity of TCT and DNA quantitative cytology test were not statistically significant (P> 0.05); TCT combined with quantitative and cytological methods of TCT alone and TCT detection sensitivity and specificity were statistically significant (P <0.01). There was no significant difference between TCT combined with DNA quantitative cytology and DNA quantitative cytometry (P> 0.05), and the specificity was significant (P <0.01). 3. ASCUS patients cervical lesions detection rate was 56.25%. In ASCUS patients, DNA quantification cytology was used as shunt method. The positive rate was 74.00% in positive group and 26.67% in negative group. There was a significant difference between the two groups (P <0.01) There was a significant difference between the positive group and ASCUS in the rate of non-shunting (P <0.05). Conclusion DNA quantitative analysis and liquid-based thin-layer cytology combined screening can improve the sensitivity and specificity of cervical precancerous lesions and cervical cancer screening, and has a shunt effect on the cytology of ASCUS.