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外科研究与新技术（中英文）

外科研究与新技术 ›› 2022, Vol. 11 ›› Issue (4): 238-241.doi: 10.3969/j.issn.2095-378X.2022.04.004

• 论著 • 上一篇    下一篇

细胞DNA图像自动分析技术（DNA-ICM）在宫颈癌筛查中的应用价值

姚琼, 刘秀芬, 盛友华   

  1. 上海市奉贤区中心医院病理科,上海 201499
  • 收稿日期:2022-08-03 出版日期:2022-12-28 发布日期:2023-03-20
  • 通讯作者: 盛友华,电子信箱：shengyouh@163.com
  • 作者简介:姚 琼（1971—）,女,大学本科,主治医师,从事临床病理科工作
  • 基金资助:
    上海市奉贤区科委基金（20181902）

Application of automatic DNA image cytometry （DNA-ICM） in cervical cancer screening

YAO Qiong, LIU Xiufen, SHENG Youhua   

  1. Department of Pathology, Shanghai Fengxian District Central Hospital, Shanghai 201499, China
  • Received:2022-08-03 Online:2022-12-28 Published:2023-03-20

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摘要： 目的 探讨细胞DNA图像自动分析技术（DNA-ICM）在宫颈癌筛查中的应用价值。方法 选取10例DNA含量均为二倍体的正常宫颈组织作为对照组,69例无上皮内病变或恶性病变（NILM）、30例低级别鳞状上皮内病变（LSIL）、65例高级别鳞状上皮内病变（HSIL）、28例鳞形细胞癌（SCC）作为实验组,实验操作采用液基细胞制片仪制片3张,分别做巴氏染色细胞学筛查、Feulgen染色后DNA图像自动扫描与倍体分析、Ki-67免疫细胞化学染色。结果 DNA-ICM及HPV筛查SIL+的灵敏度为65.9%、84.6% （χ2=34.217,P<0.001）,特异度为72.5%、55.1%（χ2=10.340,P = 0.006）;NILM、LSIL、HSIL、SCC的DI阈值分别为≤4、≤4、≤6、≤5;异倍体细胞平均个数分别为0.9、3.9、9.4、12.0,Ki-67阳性细胞平均个数分别为3.1、10.5、88.6、255.6,两组检测组间具有显著性差异（χ2=14.680, P<0.05）;出现少量（≤2个）异倍体细胞的占比分别为10.1%、33.3%、26.1%、28.6%。在低、中、高危型HPV分组中细胞DNA异倍体的检出率分别为12.1%、57.5%、82.3%,组间具有显著性差异 （χ2=43.420, P<0.001）。结论 DNA指数（DI）反映了细胞周期中的DNA的结构与数量变化,DNA异倍体细胞的数量和DI阈值对细胞学的诊断、增殖的活跃度评估及病变的进展都具有重要的应用价值。

关键词: 宫颈癌, 上皮内病变, 人乳头瘤病毒, DNA图像自动分析, 诊断

Abstract: Objective To investigate the application value of cellular antomatic DNA image cytometry （DNA-ICM） in cervical cancer screening. Methods Ten cases of normal cervical tissues with diploid DNA content were selected as the control group; 69 cases of no intraepithelial or malignant lesions （NILM）, 30 cases of low grade squamous intraepithelial leisons （LSIL）, 65 cases of high grade squamous intraepithelial leisions （HSIL）, and 28 cases of squamous cell carcinoma （SCC） were selected as the experimental groups. Pap staining cytological screening, automatic DNA-ICM and ploidy analysis after Feulgen staining, and Ki-67 immunocytochemical staining were performed. Results The sensitivity of DNA-ICM and HPV SIL+ screening was 65.9% and 84.6% （χ2=34.217, P<0.001）, and the specificity was 72.5% and 55.1% （χ2=10.340, P = 0.006） respectively. The DI thresholds of NILM, LSIL, HSIL, and SCC were ≤4, ≤4, ≤6, and ≤5, respectively. The average number of anploid cells was 0.9, 3.9, 9.4, and 12.0, and the average number of Ki-67 positive cells was 3.1, 10.5, 88.6, and 255.6, respectively, with a significant difference between the two groups （χ2=14.680, P<0.05）. The proportion of few （≤2） anploid cells was 10.1%, 33.3%, 26.1%, and 28.6%, respectively. The detection rates of cell DNA heteroploidy in the low, medium, and high risk HPV groups were 12.1%, 57.5%, and 82.3%, respectively, with a significant difference among the groups （χ2=43.420, P<0.001）. Conclusion DNA index （DI） reflects the structural and quantitative changes of DNA during the cell cycle. The number and DI threshold of DNA anploid cells have important application values for cytological diagnosis, evaluation of proliferation activity and progression of lesions.

Key words: Cervical cancer, Intraepithelial lesions, Human papillomavirus, Automatic DNA image cytometry, Diagnosis

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