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
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.