用细胞DNA定量分析方法进行子宫颈癌普查的临床研究..doc

用细胞DNA定量分析方法进行子宫颈癌普查的临床研究 作者：孙小蓉,李玉兰，车东媛武汉兰丁肿瘤早期诊断检测中心 武汉 430022；2.武汉市计划生育委员会 武汉 430022）?【摘要】 目的 探索用细胞DNA定量分析方法进行子宫颈癌普查，提高普查的工作效率和准确性。方法 对参与子宫颈癌普查的20000名妇女取材，进行液基薄层制片，然后分别进行巴氏染色和DNA染色。由细胞病理学医生对巴氏染色片子做常规细胞检查，用全自动DNA倍体分析系统对DNA染色片子进行自动扫描诊断。结果 对常规细胞检查结果在LSIL以上病例和全自动DNA倍体分析系统检查可见异倍体细胞或异倍细胞峰的病例，建议进一步做阴道镜检查以及子宫颈活检。参加普查妇女中，有1016位妇女做了病理活检。以病理诊断结果为标准，计算出细胞DNA定量分析方法在筛查CIN3以上子宫颈病变的敏感度为82%，特异度为71%，而常规细胞学方法则分别为52%和92%。结论 细胞DNA定量分析方法在有条件的降低特异度情况下，能明显提高宫颈癌普查的阳性检出率。?【关键词】 细胞DNA定量分析；全自动DNA倍体分析系统；宫颈癌；常规细胞学?Cervical cancer screening by using DNA quantitative cytology?SUN Xiao-rong, LI Yu-Lan, CHE Dong-yuan, Yan Xiang-chen, Ling Hui-fang, Tu Hong-zhang, Wang Jian.?(1.Landing Center for Early Detection of Cancer, Wuhan 430022, China; 2. Family Plan Committe of Wuhan City, Wuhan 430022, China)?【Abstract】 Objective To increase the sensitivity of cervical cancer screening by using DNA quantitative cytology. Methods A total of 20000 women were involved in this study. Cervical samples were taken by a cervix brush. Monolayer of cells were deposited onto microscope slides by liquid-based sampling 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 method for determination of amount of DNA using a automated DNA imaging cytometry. Results All cases of LSIL, HSIL and cancer decided by conventional cytology and all cases with DNA amount greater than 5C (DNA Index2.5) cells decided by automated DNA imaging cytometry were sent to colposcopy and biopsy. A total of 1016 women were followed by colposcopy examination where biopsies were taken. The sensitivity of 82% at specificity of 71% were calculated for DNA quantitative cytology and sensitivity of 52% at 92% specificity for conventional cytology. Conclusions The screening for high grade cervical neoplastic lesions and cervical cancer by fully automated imaging cytometry could be higher sensitivity under certain specifi