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[目的]探索DNA定量分析方法作为食管癌癌前病变的初筛方法的可行性。[方法]选取食管癌高发区林州市40～69岁内镜筛查确诊的食管癌及其各级癌前病变患者79例,通过脱落细胞学检查获得食管上皮细胞标本,双盲进行液基细胞学和DNA定量分析诊断。基于病理诊断结果,比较DNA定量分析与液基细胞学的筛查能力。[结果]基于中度不典型增生及以上,DNA定量分析中至少2个异倍体细胞数的灵敏度86.0%,特异度65.5%,优于细胞学≥ASCUS灵敏度为82.0%,特异度为65.5%;DNA定量分析≥4个异倍体细胞数或≥ASCUS的灵敏度和特异度分别为90.0%和62.1%。[结论]DNA定量分析方法初筛食管癌及其癌前病变的灵敏度与特异度略优于液基细胞学,在诊断效率、重现性、预后预测等方面颇具优势。作为初筛方法具有可行性,但尚需大样本量人群筛查验证。
[Objective] To explore the feasibility of DNA quantification as a screening method for esophageal precancerous lesions. [Method] Select 79 cases of esophageal cancer and its precancerous lesion confirmed by endoscopic screening of 40 ~ 69 years old in Linzhou, a high risk area of esophageal cancer. Esophageal epithelial cells were obtained by exfoliative cytology examination. Cytology and DNA Quantitative Analysis Diagnosis. Based on the pathological findings, DNA quantification and liquid-based cytological screening were compared. [Results] The sensitivity and specificity of at least 2 aneuploid cells in quantitative analysis of DNA were 86.0% and 65.5% based on moderate dysplasia and above, respectively, which was better than cytology ≥ASCUS with a sensitivity of 82.0% and a specificity of 65.5% ; The sensitivity and specificity of DNA quantitative analysis ≥ 4 aneuploid cells or ≥ ASCUS were 90.0% and 62.1%, respectively. [Conclusion] The sensitivity and specificity of DNA quantitative analysis for screening primary esophageal cancer and its precancerous lesions are slightly better than that of liquid-based cytology, which has advantages in diagnosis efficiency, reproducibility and prognosis prediction. As a screening method is feasible, but still need a large sample size screening verification.