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用细胞DNA定量分析方法进行宫颈癌普查的临床研究

Cervical cancer screening by using DNA quantitative cytology

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【作者】 孙小蓉李玉兰车东媛晏想成凌慧芳凃洪章汪键

【Author】 SUN Xiɑo-ronɡ1, LI Yu-lɑn2, CHE Donɡ-yuɑn1, et al. (1.Landing Center for Early Detection of Cancer,Wuhɑn 430032,China; 2.Family P lan Committe of Wuhɑn City,Wuhɑn 430022,China)

【机构】 武汉兰丁肿瘤早期诊断检测中心武汉市计划生育委员会武汉兰丁肿瘤早期诊断检测中心 武汉430032武汉430022武汉430032武汉430032

【摘要】 目的 探索用细胞DNA定量分析方法进行宫颈癌普查 ,以提高普查的工作效率和准确性。方法 对参与宫颈癌普查的 2 0 0 0 0名妇女用宫颈刷取材 ,进行液基薄层制片 ,分别进行巴氏染色和DNA染色。对巴氏染色片做常规细胞学检查 ,对DNA染色片进行自动扫描诊断。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体细胞峰的病例 ,建议进一步做阴道镜检查以及宫颈活检。 10 16名妇女做了病理活检。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以上宫颈病变的敏感性为82 % ,特异性为 71% ,而常规细胞学方法则分别为 5 2 %和 92 %。结论 细胞DNA定量分析方法在有条件的降低特异性的情况下 ,能明显提高宫颈癌普查的阳性检出率。

【Abstract】 Objective To increase the sensitivity of cervical cancer screening by using DNA quantitative cytology. Methods A total of 20 000 women were involved in this study. Cervical samples were taken by a cervical brush. Monolayer of cells were deposited onto microscopic sl ides by liquid-based sampling preparation. Two slides were prepared from each case: one slide was stained by Papanicolaou stain for conventional cytology examinatio n, while the other slide was stained by Feulgen method for determination of amou n t of DNA using an automated DNA imaging cytometry. Results All ca ses of LSIL,HSIL and cancer decided by conventional cytology and all cases with DNA amount greater than 5C (DNA Index>2.5) cells decided by automated DNA imagi ng cytometry were sent to colposcopy and biopsy. A total of 1016 women were follow e d by colposcopic examination where biop s ies were taken. The sensitivity of 82% at specificity of 71% were calculated for DNA quantitative cytology and sensitivity of 52% at 92% specificity for conventi onal cytology. Conclusion The screening for high grade cervica l neoplastic lesions and cervical cancer by fully automated imaging cytometry co uld be higher sensitivity under certain specificity.

【基金】 国家“九五”科技攻关生物医学工程项目 (96 90 1 0 7 0 3 ) ;武汉市科委重点攻关项目 (2 0 0 60 0 10 10 )。
  • 【文献出处】 诊断病理学杂志 ,Chinese Journal of Diagnostic Pathology , 编辑部邮箱 ,2005年01期
  • 【分类号】R737.33
  • 【被引频次】90
  • 【下载频次】511
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