中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2013年
12期
829-832
,共4页
梅金红%徐姗%韩永良%涂轶%熊一峰%余燕青
梅金紅%徐姍%韓永良%塗軼%熊一峰%餘燕青
매금홍%서산%한영량%도질%웅일봉%여연청
宫颈疾病%癌前状态%细胞学技术%DNA突变分析%病理学,临床
宮頸疾病%癌前狀態%細胞學技術%DNA突變分析%病理學,臨床
궁경질병%암전상태%세포학기술%DNA돌변분석%병이학,림상
Uterine cervical diseases%Precancerous conditions%Cytological techniques%DNA mutational analysis%Pathology,clinical
目的 通过DNA定量分析与薄层液基细胞学检查,探讨不能明确意义的不典型鳞状细胞(ASCUS)伴DNA倍体异常在宫颈早期病变筛查中的意义.方法 对8448例患者进行DNA定量分析和液基细胞学检查,对1041例检出DNA倍体异常和(或)液基细胞学异常者进行宫颈组织学活检,分析其中247例ASCUS伴DNA倍体异常患者的组织学诊断情况.结果 (1)在8448例标本中,正常或良性细胞学7877例,ASCUS 426例,不除外高级别鳞状上皮内瘤变的不典型鳞状细胞(ASC-H)45例,低级别鳞状上皮内瘤变(LSIL) 55例,高级别鳞状上皮内瘤变(HSIL) 22例,其中伴1～2个DNA异倍体细胞者所占比例分别为5.6％(443/7877)、15.3％(65/426)、11.1％ (5/45)、9.1％ (5/55)、0(0/22);伴≥3个异倍体细胞者所占比例分别为1.0％(77/7877)、39.0％ (166/426)、75.6％ (34/45)、76.4％ (42/55)、95.5％ (21/22).(2)247例ASCUS患者在阴道镜下进行宫颈活检,宫颈上皮内瘤变(CIN)2及以上病变者67例;伴]～2个DNA异倍体细胞者36例,其中5例(13.9％,5/36)为CIN 2及以上病变;伴≥3个异倍体细胞者123例,其中56例(45.5％,56/123)为CIN 2及以上病变;DNA倍体正常者88例,其中6例(6.8％,6/88)为CIN 2及以上病变.ASCUS中伴]～2个DNA异倍体细胞组与伴≥3个异倍体细胞组比较,差异有统计学意义(X2=11.79,P＜0.01);与DNA倍体正常组比较,差异无统计学意义(P＞0.05).结论 ASCUS伴≥3个异倍体细胞者患CIN 2及以上病变的风险更高.DNA定量分析与薄层液基细胞学检查两者联合检测可为分流ASCUS患者、指导临床随访和治疗提供帮助.
目的 通過DNA定量分析與薄層液基細胞學檢查,探討不能明確意義的不典型鱗狀細胞(ASCUS)伴DNA倍體異常在宮頸早期病變篩查中的意義.方法 對8448例患者進行DNA定量分析和液基細胞學檢查,對1041例檢齣DNA倍體異常和(或)液基細胞學異常者進行宮頸組織學活檢,分析其中247例ASCUS伴DNA倍體異常患者的組織學診斷情況.結果 (1)在8448例標本中,正常或良性細胞學7877例,ASCUS 426例,不除外高級彆鱗狀上皮內瘤變的不典型鱗狀細胞(ASC-H)45例,低級彆鱗狀上皮內瘤變(LSIL) 55例,高級彆鱗狀上皮內瘤變(HSIL) 22例,其中伴1～2箇DNA異倍體細胞者所佔比例分彆為5.6％(443/7877)、15.3％(65/426)、11.1％ (5/45)、9.1％ (5/55)、0(0/22);伴≥3箇異倍體細胞者所佔比例分彆為1.0％(77/7877)、39.0％ (166/426)、75.6％ (34/45)、76.4％ (42/55)、95.5％ (21/22).(2)247例ASCUS患者在陰道鏡下進行宮頸活檢,宮頸上皮內瘤變(CIN)2及以上病變者67例;伴]～2箇DNA異倍體細胞者36例,其中5例(13.9％,5/36)為CIN 2及以上病變;伴≥3箇異倍體細胞者123例,其中56例(45.5％,56/123)為CIN 2及以上病變;DNA倍體正常者88例,其中6例(6.8％,6/88)為CIN 2及以上病變.ASCUS中伴]～2箇DNA異倍體細胞組與伴≥3箇異倍體細胞組比較,差異有統計學意義(X2=11.79,P＜0.01);與DNA倍體正常組比較,差異無統計學意義(P＞0.05).結論 ASCUS伴≥3箇異倍體細胞者患CIN 2及以上病變的風險更高.DNA定量分析與薄層液基細胞學檢查兩者聯閤檢測可為分流ASCUS患者、指導臨床隨訪和治療提供幫助.
목적 통과DNA정량분석여박층액기세포학검사,탐토불능명학의의적불전형린상세포(ASCUS)반DNA배체이상재궁경조기병변사사중적의의.방법 대8448례환자진행DNA정량분석화액기세포학검사,대1041례검출DNA배체이상화(혹)액기세포학이상자진행궁경조직학활검,분석기중247례ASCUS반DNA배체이상환자적조직학진단정황.결과 (1)재8448례표본중,정상혹량성세포학7877례,ASCUS 426례,불제외고급별린상상피내류변적불전형린상세포(ASC-H)45례,저급별린상상피내류변(LSIL) 55례,고급별린상상피내류변(HSIL) 22례,기중반1～2개DNA이배체세포자소점비례분별위5.6％(443/7877)、15.3％(65/426)、11.1％ (5/45)、9.1％ (5/55)、0(0/22);반≥3개이배체세포자소점비례분별위1.0％(77/7877)、39.0％ (166/426)、75.6％ (34/45)、76.4％ (42/55)、95.5％ (21/22).(2)247례ASCUS환자재음도경하진행궁경활검,궁경상피내류변(CIN)2급이상병변자67례;반]～2개DNA이배체세포자36례,기중5례(13.9％,5/36)위CIN 2급이상병변;반≥3개이배체세포자123례,기중56례(45.5％,56/123)위CIN 2급이상병변;DNA배체정상자88례,기중6례(6.8％,6/88)위CIN 2급이상병변.ASCUS중반]～2개DNA이배체세포조여반≥3개이배체세포조비교,차이유통계학의의(X2=11.79,P＜0.01);여DNA배체정상조비교,차이무통계학의의(P＞0.05).결론 ASCUS반≥3개이배체세포자환CIN 2급이상병변적풍험경고.DNA정량분석여박층액기세포학검사량자연합검측가위분류ASCUS환자、지도림상수방화치료제공방조.
Objective To investigate the clinical significance of atypical squamous cells of unknown significance (ASCUS) with abnormal DNA ploidy in the early diagnosis of cervical lesions.Methods Eight thousand four hundred and forty-eight patients were included in this study and all had DNA quantitative analysis and cervical liquid-based cytology.Among 1041 cases with DNA aneuploidy and/or abnormal cervical liquid-based cytology and additional cervical biopsy,histological review was performed in 247 ASCUS cases with abnormal DNA ploidy.Results (1) Among 8448 cases,7877 were normal or benign,426 were ASCUS,45 were ASC-H,55 were LSIL and 22 were HSIL by TBS diagnosis.The presence of 1-2 abnormal DNA ploidy cells was detected in 15.3％ (65/426) of ASCUS,11.1％ (5/45) of ASC-H,9.1％ (5/55) of LSIL,and 0 (0/22) of HSIL.The presence of ≥ 3 abnormal DNA ploidy cells was detected in 39.0％ (166/426) of ASCUS,75.6％ (34/45) of ASC-H,76.4％ (42/55) of LSIL,and 95.5％ (21/22) of HSIL.(2) A total of 67 cases of CIN 2,CIN 3 or cancers were found in 247 patients with ASCUS by colposcopy biopsies,of which 13.9％ (5/36) had 1-2 abnormal DNA ploidy cells,45.5％ (56/123) had ≥3 abnormal DNA ploidy cells and 6.8％ (6/88) had normal DNA polidy.ASCUS with 1-2 abnormal DNA ploidy cells and with ≥ 3 abnormal DNA ploidy cells were compared.The difference was statistically significant (x2 =11.79,P ＜0.01).But the difference between ASCUS with 1-2 abnormal DNA ploidy cells and normal DNA ploidy had no statistical significance (P ＞ 0.05).Conclusions ASCUS with ≥3 abnormal DNA ploidy cells has higher risk for developing CIN 2,CIN 3 or invasive carcinoma.The application of DNA quantitative analysis and cervical liquid-based cytology test can help in guiding clinical follow-up and treatment options in patients with ASCUS.
