CAJ | 학술논문

目的：探讨提高宫颈病变筛查检出率的最有效途径。方法对体检中心参加宫颈癌筛查的12000名妇女进行宫颈液基细胞学筛查(TCT)及DNA 倍体分析。结果 TCT异常者检出率为6.0%(720/12000)。其中，非典型鳞状上皮细胞(ASC-US)为2.5%(300/12000)，低度鳞状上皮内病变(LSIL)为2.1%(252/12000)，高度鳞状上皮内病变( HSIL)及以上为1.4%(168/12000)。DNA倍体分析异常为5.9%(713/12000)。若组织学CINI及以上级别为需要处理癌前病变的标准，液基细胞学方法敏感度为58.0%（237/408），特异度为88.0%（669/756），阳性预测值为73.1%（237/324），阴性预测值为79.6%（669/840）；DNA倍体分析方法敏感度为80.1%（327/408），特异度为70.1%（530/756），阳性预测值为59.1%（327/553），阴性预测值为86.7%（530/611）；液基细胞学联合DNA倍体分析方法敏感度为81.4%（332/408），特异度为65.7%（497/756），阳性预测值为56.2%（332/591），阴性预测值为86.7%（497/573）。结论液基细胞学联合应用DNA倍体分析，能提高宫颈癌前病变及宫颈癌筛查的检出率。
목적：탐토제고궁경병변사사검출솔적최유효도경。방법대체검중심삼가궁경암사사적12000명부녀진행궁경액기세포학사사(TCT)급DNA 배체분석。결과 TCT이상자검출솔위6.0%(720/12000)。기중，비전형린상상피세포(ASC-US)위2.5%(300/12000)，저도린상상피내병변(LSIL)위2.1%(252/12000)，고도린상상피내병변( HSIL)급이상위1.4%(168/12000)。DNA배체분석이상위5.9%(713/12000)。약조직학CINI급이상급별위수요처리암전병변적표준，액기세포학방법민감도위58.0%（237/408），특이도위88.0%（669/756），양성예측치위73.1%（237/324），음성예측치위79.6%（669/840）；DNA배체분석방법민감도위80.1%（327/408），특이도위70.1%（530/756），양성예측치위59.1%（327/553），음성예측치위86.7%（530/611）；액기세포학연합DNA배체분석방법민감도위81.4%（332/408），특이도위65.7%（497/756），양성예측치위56.2%（332/591），음성예측치위86.7%（497/573）。결론액기세포학연합응용DNA배체분석，능제고궁경암전병변급궁경암사사적검출솔。
Objective We aimed to investigate an effective approach to improve detection rate for screening the cervical lesions. Methods The TCT analysis,DNA ploidy analysis were used to screen the women coming to our Health Check Centre. Results The detection rate of TCT abnormalities was 6%(720/12 000) ,of which detection rate of ASC-US was 2.5%(300/12 000) ,LSIL was 2.1%(252/12 000) ,HSIL and above were 1.4%(168/12 000). The abnormal DNA ploidy analysis occurred in 5.94%(713/12 000). For the TCT analysis,the sensitivity of 58.0%,the peculiarity of 88.0%,the positive predictive value of 73.1%,the negative predictive value of 79.6%were calculated for cases of CINI or above;for DNA ploidy analysis,the sensitivity of 80.1%and specificity of 70.1%and positive predictive value of 59.1%and negative predictive value of 86.7%were calculated for cases of CINI or above;for TCT combined with the DNA ploidy analysis,sensitivity of 81.4%,the peculiarity of 65.7%,the positive predictive value of 56.2%,the negative predictive value of 86.7%were calculated for cases of CINI or above. Conclusion The TCT screening combined with DNA ploidy analysis might improve the detection rate of cervical precancerous lesions and early cervical carcinoma.