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目的利用显微图像分析技术对宫颈脱落细胞做DNA倍体检测、分析,以探讨该技术在宫颈癌及癌前病变筛查中的应用价值。方法对619例宫颈脱落细胞样本分别采用常规细胞学镜检和细胞DNA倍体分析法作检测,其中阳性样本患者行组织活检,并将3种检测结果进行对比分析。结果 619例样本,常规细胞学镜检共检出ASC-US 42例、ASC-H 6例、LSIL 29例、HSIL18例;采用细胞倍体分析法检出DI≥2.5时,可见DNA倍体异常细胞(1~2个)的样本102例、DNA倍体异常细胞(≥3个)的样本41例、DNA倍体异常细胞(≥25个)的样本14例;48例组织活检样本检出炎症7例、CINⅠ20例,CINⅡ13例、CINⅢ2例、IC 6例。CINⅡ~Ⅲ对应TBS系统中的HSIL计算灵敏度为81.0%;对应SIL和对应ASC+SIL的灵敏度分别为85.7%和100%。HSIL与CINⅡ~Ⅲ比较有非常显著的统计学意义。CINⅡ~Ⅲ对应DNA倍体异常细胞(≥25个)计算灵敏度为66.7%;对应可见DNA倍体异常细胞(≥3个)的灵敏度为100%。DNA倍体异常细胞(≥25个)与CINⅡ~Ⅲ比较也有非常显著的统计学意义。结论细胞DNA倍体图像分析法在宫颈癌及癌前病变筛查中有较高的灵敏度,若联合常规宫颈细胞学检查,可明显提高宫颈癌筛查的质量控制水平。
Objective To analyze the DNA ploidy of cervical exfoliated cells using microscopic image analysis technique to explore the value of this technique in screening cervical cancer and precancerous lesions. Methods 619 samples of cervical exfoliated cells were detected by routine cytology and DNA ploidy analysis respectively. The positive samples were biopsied and the results of three tests were compared. Results Among the 619 samples, 42 cases of ASC-US, 6 cases of ASC-H, 29 cases of LSIL and 18 cases of HSIL were detected by routine cytology. DNA diopters were detected when the cell number was DI≥2.5 There were 102 samples of cells (1 ~ 2), 41 samples of DNA ploidy (≥3), 14 samples of DNA ploidy (≥25), and 48 samples of tissue biopsy 7 cases, CINⅠ20 cases, CINⅡ13 cases, CINⅢ2 cases, IC 6 cases. The sensitivity of HSIL in CINⅡ-Ⅲ corresponding TBS system is 81.0%, and the sensitivity of corresponding SIL and corresponding ASC + SIL is 85.7% and 100%, respectively. HSIL and CIN Ⅱ ~ Ⅲ have very significant statistical significance. The calculated sensitivity of DNA ploidy abnormal cells (≥25) for CINⅡ ~ Ⅲ was 66.7%. The corresponding sensitivity of DNA ploidy abnormal cells (≥3) was 100%. DNA ploidy abnormal cells (≥ 25) compared with CIN Ⅱ ~ Ⅲ also had a very significant statistical significance. Conclusion DNA ploidy image analysis has high sensitivity in screening cervical cancer and precancerous lesions. Combined with routine cervical cytology, it can significantly improve the quality control of cervical cancer screening.