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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.
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基本信息:
中图分类号:R737.33
引用信息:
[1]孙小蓉,李玉兰,车东媛,晏想成,凌慧芳,凃洪章,汪键.用细胞DNA定量分析方法进行宫颈癌普查的临床研究[J].诊断病理学杂志,2005(01).
基金信息:
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 )。