论著 Original Article

细胞DNA定量分析及高危型HPV-DNA检测在宫颈病变筛查中的应用

Published at: 2017年第37卷第4期

王双双 1 , 李惠 1 , 唐福婷 1 , 吴晓斌 1
1 南京中医药大学附属江苏省中医院病理科,南京 210029
通讯作者 晓斌 吴 Email: wuxbin2000@163.com
DOI: 10.3978/j.issn.2095-6959.2017.04.024
基金:

摘要

目的:分析细胞DNA定量和高危型人乳头状瘤病毒(human papillomavirus,HPV)DNA检测在宫颈病变筛查中的作用。方法:选取2015年5月至2016年9月间在江苏省中医院同时行DNA倍体分析及薄层液基细胞学检查(thin-cytologic test,TCT)的5 042例妇女,其中1 573例行HPV检测,146例行病理活检。结果:宫颈病变筛查病例中DNA倍体异常390例,阳性率7.74%,TCT异常病例408例,阳性率8.10%,两者相比差异无统计学意义(P>0.05)。其中<3个细胞且2.5≤DI<4.5者TCT阳性率为33.74%;≥3个细胞且2.5≤DI<4.5者,TCT阳性率为94.74%;DI≥4.5者,其TCT阳性率为98.5%,差异具有统计学意义(P<0.01)。不能明确意义的非典型鳞状上皮细胞,低度鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)及高度鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)病例DNA倍体定量分析阳性率分别为45.42%,97.14%和100%,差异具有统计学意义(P<0.01)。高危型HPV总体感染率为24.5%,并且随着DI指数的升高,高危型HPV感染率也随之升高,具有统计学意义(P<0.01),DNA倍体异常病例及DNA倍体异常且TCT异常病例高危型HPV感染率分别为56.8%和60.4%,差异无统计学意义(P>0.05)。DNA倍体异常病例阴道镜活检组织病理学阳性率为70.5%,TCT异常病例阳性率为65.9%,两者差异无统计学意义(P>0.05),总体检出率为74.6%。结论:细胞DNA定量分析是一种有效的宫颈病变筛查方法。


Application of DNA quantitative cytology and high-risk HPV-DNA test in screening cervical lesions

Abstract

Objective: To analysis the role of DNA quantitative cytology and high risk HPV-DNA testing in screening of cervical lesions. Methods: We analyzed the data of 5 024 patients who were detected both by DNA ploidy analysis and cervical liquid-based cytology from May 2015 to September 2016 in Jiangsu Province Traditional Chinese Medicine Hospital, among which 1 573 patients were detected by HPV. A total of 146 women were followed by colposcopic examination, where biopsies were taken. Results: Positive rate was 7.74% in 390 patients with DNA ploidy abnormality and it was 8.1% in 408 patients detected by TCT, there was no significant difference (P>0.05). The TCT positive rate were 33.7%, 94.7% and 98.5% when the 2.5≤DI<4.5 less than 3 cells, 2.5≤DI<4.5 more than 3 cells, DI ≥4.5, respectively, and there was statistically significant difference (P<0.01). The positive rates of DNA ploidy quantitative analysis of ASC-US, low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) were 45.4%, 97.1% and 100%, respectively. The difference was statistically significant (P<0.01). The total high-risk HPV infection rate was 24.5%, and with the increase of DI index, the rate of high-risk HPV infection was increasing, with statistical significance (P<0.01). Histologically positive rate of biopsy was 70.5% with DNA ploidy while TCT was 65.9%, the difference was not statistically significant (P>0.05), the total detection rate was 74.6%. Conclusion: DNA quantitative cytology is an effective method of cervical lesion screening.


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引用

引用本文: 双双 王, 惠 李, 福婷 唐, 晓斌 吴. 细胞DNA定量分析及高危型HPV-DNA检测在宫颈病变筛查中的应用[J]. 临床与病理杂志, 2017, 37(4): 791-795.
Cite this article as: WANG Shuangshuang, LI Hui, TANG Futing, WU Xiaobin . Application of DNA quantitative cytology and high-risk HPV-DNA test in screening cervical lesions[J]. Journal of Clinical and Pathological Research, 2017, 37(4): 791-795.