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DNA定量分析和高危型HPV-DNA检测在ASCUS分流诊断中的意义

Significance of DNA Quantitative Cytology and High-risk HPV-DNA Test in ASCUS Triage Diagnosis

  • 摘要: 目的 探讨细胞DNA定量分析和高危型HPV-DNA定量检测在未明确意义非典型鳞状上皮细胞( atypical squamous cells of undetermined signification,ASCUS)诊断分流中的意义。 方法 DNA定量分析组:193例行DNA定量分析;高危型HPV-DNA检测组:134例行高危型HPV-DNA检测。巴氏(the Bethesda system, TBS)系统诊断为ASCUS的327例患者均行阴道镜检及镜下活检。 结果 327例ASCUS中,阴道镜活检病理诊断为炎症者204例(62.39%),CINⅠ70例(21.41%),CINⅡ13例(3.98%),CINⅢ 30例(9.17%),宫颈癌10例(3.05%)。高危型HPV-DNA检测组和DNA定量分析组之间阴道镜活检病理检查结果比较差异无统计学意义。DNA定量分析和HPV-DNA检测预测CINⅡ及以上的阴性预测值分别为98.93%和94.74%。每100个被测细胞数中异倍体细胞不同百分比比较,<0.1%和≥0.1%的阴道镜活检结果差异有统计学意义。≥3个DNA异倍体预测CINⅡ及以上病理改变,其敏感度、特异性、阳性预测值、阴性预测值分别为80.64%、47.06%、40.99%、84.21%。 结论 DNA定量分析和高危型HPV-DNA检测可用于ASCUS的分流,但DNA定量分析更经济。

     

    Abstract: Objective To explore the significance of DNA quantitative cytology and High-risk HPV-DNA testing in ASCUS riage diagnosis. Methods The DNA quantitative cytology group included 193 cases and the high-risk HPV-DNA comprises 134 cases.ASCUS diagnosed by TBS undergone with automatic cell tumour check analysis system or High-risk HPV-DNA test later, were both done colposcopy directed biopsy soon.There was a comparison between these two cases in pathological results. Results Of the 327 ASCUS cases, 204 cases were histologically diagnosed as inflammation (62.39%), 70 cases were CIN Ⅰ(21.41%), 13 cases were CINⅡ(3.98%), 30 cases were CIN Ⅲ (9.17%),and 10 cases were cervical invasive cancer (3.05%).The histological diagnosis were no statistical distinction between HR-HPV-DNA and DNA Quantitative cytology groups. The negative predictive values of HPV-DNA and DNA Quantitative cytology were 94.74% and 98.93%,respectively. Compared with the percentage of DNA amount greater than 5C (DNA Index>2.5) cells, the histological diagnosis were significantly different between <0.1% and ≥0.1% .DNA heteroploid more than or equal to three were used to predict CINⅡor more severe pathological changes, and its sensitivity, specificity, positive predictive values and negative predictive values were 80.64%,47.06%,40.99%,84.21%, respectively. Conclusion DNA Quantitative cytology and High-risk HPV-DNA test can be used for ASCUS triage, but the cost of DNA Quantitative cytology is cheaper than High-risk HPV-DNA test.

     

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