Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2018, Vol. 14 ›› Issue (05): 602 -607. doi: 10.3877/cma.j.issn.1673-5250.2018.05.018

Special Issue:

Original Article

Screening values of cervical DNA ploidy analysis combined with cervical cytology test for cervical cancer

Xia Li1, Yuedong He2,()   

  1. 1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China; Department of Gynecology, Chinese Traditional Medicine Hospital of Leshan City, Leshan 614000, Sichuan Province, China
    2. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2018-06-21 Revised:2018-09-05 Published:2018-10-01
  • Corresponding author: Yuedong He
  • About author:
    Corresponding author: He Yuedong, Email:
  • Supported by:
    Science and Technology Pillar Program by Science and Technology Department of Sichuan Province(2015FZ0059)
Objective

To explore the screening values of cervical DNA ploidy analysis combined with cervical cytology test for cervical cancer.

Methods

A total of 862 women who underwent cervical cancer screening in West China Second University Hospital, Sichuan University from January 1 to October 31, 2016 were selected as research subjects by retrospective study method. All participants received cervical DNA ploidy analysis and cervical ThinPrep liquid-based cytology test (TCT). Those who were positive for cervical DNA ploidy analysis or TCT were examined by colposcopy, and cervical tissues were taken for pathological examination. Cervical biopsy results were taken as the " gold standard" . The sensitivities, specificities, positive predictive values and negative predictive values of three screening methods including cervical DNA ploidy analysis, TCT, and the combination of these two methods for screening cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+ ). The screening values of these three screening methods for CIN2+ were compared. The procedures in this study were in line with the requests of the World Medical Association Declaration of Helsinki revised in 2013.

Results

①The histopathological diagnosis results of those 862 subjects in this study were as follows. There were 655 cases (76.0%) of normal cervical tissue, 109 cases (12.7%) of CIN1, 45 cases (5.2%) of CIN2, 39 cases (4.5%) of CIN3, 14 cases (1.6%) of cervical cancer, and the detection rate of CIN2+ was 11.4% (98/862). The results of cervical DNA ploidy analysis showed that there were 280 cases (32.5%) of subjects with positive results, among whom 94 cases were CIN2+ , and the detection rate of CIN2+ was 10.9% (94/862). The results of TCT showed that 272 cases (31.6%) with positive results of TCT were detected, among whom 93 cases were CIN2+ , and detection rate of CIN2+ was 10.8% (93/862). The cervical DNA ploidy analysis combined with TCT screening results showed that 308 cases (35.7%) were with positive results, among whom 95 cases were CIN2+ , and the detection rate of CIN2+ was 11.0% (95/862). ② Sensitivities of cervical DNA ploidy analysis, TCT and the combination of those two methods for the screening of CIN2+ were 95.9% (94/98), 94.9% (93/98) and 96.9% (95/98), respectively, and specificities were 75.7% (578/764), 76.6% (585/764) and 72.1% (551/764), respectively, and positive predictive values were 33.6% (94/280), 34.2% (93/272) and 30.8% (95/308), respectively. Negative predictive values were 99.3% (578/582), 99.2% (585/590) and 99.5% (551/554), respectively. Sensitivity and negative predictive value of the combination of cervical DNA ploidy analysis and TCT for the screening of CIN2+ both were higher than those of the two methods alone.

Conclusions

Screening values of cervical DNA ploidy analysis combined with TCT for cervical precancerous lesions and cervical cancer are superior to those two methods alone, and the combination screening method can improve the screening accuracy rate for cervical lesions. Because this study is just a retrospective study, the screening values of the combination of these two methods in screening for cervical precancerous lesions and cervical cancer remains to be confirmed by large-sample, multicenter, prospective randomized controlled trials.

表1 本组862例受试者宫颈活组织病理学检查、宫颈DNA倍体分析及TCT结果比较(例)
表2 宫颈DNA倍体分析、TCT及2种方法联合筛查对宫颈活组织病理学检查诊断结果为CIN2+的筛查效能比较(例)
[1]
Siegel RL,Miller KD,Jemal A, et al. Cancer statistics, 2015[J]. CA Cancer J Clin, 2015, 65(1): 5-29.
[2]
Chen W,Zheng R,Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[3]
谢幸,苟文丽. 妇产科学[M]. 8版. 北京:人民卫生出版社,2013: 301.
[4]
Smith RA,Manassaram-Baptiste D,Brooks D, et al. Cancer screening in the United States, 2015: a review of current American Cancer Society Guidelines and current issues in cancer screening[J]. CA Cancer J Clin, 2015, 65(1): 30-54.
[5]
胡尚英,郑荣寿,赵方辉,等. 1989至2008年中国女性子宫颈癌发病和死亡趋势分析[J]. 中国医学科学院学报,2014, 36(2): 119-125.
[6]
Holt HK,Zhang L,Zhao FH, et al. Evaluation of multiple primary and combination screening strategies in postmenopausal women for detection of cervical cancer in China[J]. Int J Cancer, 2017, 140(3): 544-554.
[7]
Al-Mandeel HM,Sagr E,Sait K, et al. Clinical practice guidelines on the screening and treatment of precancerous lesions for cervical cancer prevention in Saudi Arabia[J]. Ann Saudi Med, 2016, 36(5): 313-320.
[8]
Dijkstra MG,van Zummeren M,Rozendaal L, et al. Safety of extending screening intervals beyond five years in cervical screening programmes with testing for high risk human papillomavirus: 14 year follow-up of population based randomised cohort in the Netherlands[J]. BMJ, 2016, 355: i4924.
[9]
Schiffman M,Yu K,Zuna R, et al. Proof-of-principle study of a novel cervical screening and triage strategy: computer-analyzed cytology to decide which HPV-positive women are likely to have ≥CIN2[J]. Int J Cancer, 2017, 140(3): 718-725.
[10]
Peirson L,Fitzpatrick-Lewis D,Ciliska D,et al. Screening for cervical cancer:a systematic review and Meta analysis[J]. Syst Rev, 2013, 2(1): 35.
[11]
Solomon D,Davey D,Kurman R, et al. The 2001 Bethesda System: terminology for reporting results of cervical cytology[J]. JAMA, 2002, 287(16): 2114-2119.
[12]
孙小蓉,汪健. DNA定量细胞学[M]. 武汉:湖北科学技术出版社,2011:85-90.
[13]
Richart RM. Cervical intraepithelial neoplasia[J]. Pathol Annu, 1973, 8: 301-328.
[14]
张璐. 子宫颈脱落细胞学≥ASC-US与HPV感染、DNA倍体的研究[D]. 西宁:青海大学,2015.
[15]
贺昕红,蒋国庆,李璇. DNA倍体分析在宫颈上皮内瘤变治疗后监测的临床观察[J]. 中国计划生育和妇产科,2018, 10(8): 19-21, 29.
[16]
杨永国,丁岚. DNA倍体分析与常规细胞学诊断对宫颈上皮内瘤变的诊断价值[J]. 影像研究与医学应用,2017, 1(17): 165-166.
[17]
付蒙, 杨静,吕晓杰. DNA倍体定量分析及宫颈液基细胞学诊断宫颈上皮内瘤变[J]. 中国临床医生杂志,2017, 45(4): 77-79.
[18]
吕晓杰,曹冬如,蒋红清,等. 高危型人乳头瘤病毒负荷量与宫颈细胞DNA倍体定量关系的探讨[J]. 中国妇幼保健,2015, 30(22): 3781-3783.
[19]
Smith RA,Brooks D,Cokkinides V, et al. Cancer screening in the United States, 2013: a review of current American Cancer Society guidelines, current issues in cancer screening, and new guidance on cervical cancer screening and lung cancer screening[J]. CA Cancer J Clin, 2013, 63(2): 88-105.
[20]
胡静,王冬芹. 液基细胞学联合人乳头瘤病毒-DNA检测在宫颈病变中的诊断价值[J/CD]. 中华妇幼临床医学杂志(电子版), 2013, 9(2): 222-224.
[21]
何玥,杨淑丽,赵群,等. 不同高危型人乳头瘤病毒检测方法在宫颈病变筛查中的应用 [J/CD]. 中华妇幼临床医学杂志(电子版), 2017, 13(4): 449-454.
[22]
李永红,毕晓芳,李晶. 细胞DNA定量分析技术在宫颈癌筛查中的应用研究[J]. 哈尔滨医药,2015, 15(6): 421-423.
[23]
夏静静. 细胞DNA分析技术及宫颈HPV检测在宫颈癌筛查中的应用[J]. 昆明:昆明医科大学,2014.
[24]
张雪梅,覃福宁,孙奇. 宫颈DNA倍体分析及TCT在宫颈病变早期筛查中的临床意义[J]. 重庆医学,2016, 45(14): 1974-1976.
[1] Minrong Ma, Cong Li, Qin Zhou. Current research status of treatment of cervical cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 497-504.
[2] Changsheng Lin, Jun Zhan, Xue Xiao. Genetic testing and precision molecular targeted therapy in diagnosis and treatment of epithelial ovarian caner[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 505-510.
[3] Juan Gu, Qingqing Sun, Fangfang Hu, Yijuan Cao, Yujuan Qi. Clinical application of endometrial receptivity array to improve pregnancy outcomes in women with repeated embryo implantation failure[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 582-587.
[4] Wenrong Dai, Lijuan Zhao, Zhihui Li. Research progress of influence of extracellular vesicles on embryo implantation[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 616-620.
[5] Dongjie Zhou, Min Jiang, Hairui Fan, Lingling Gao, Xiang Kong, Dan Lu, Liping Wang. Current research progress on non-coding RNA in follicular development and maturation[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(04): 387-393.
[6] Huizhu Chen, Yingkun Guo, Xinrong Wang, Gang Ning, Xijian Chen. Current research status on the " dualistic model" of epithelial ovarian cancer and its molecular biology[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(04): 394-402.
[7] Chunying Han, Tingting Wang, Yanyan Li, Jinxia Piao. Current research status on predictors of lymphatic vascular invasion in patients with endometrial carcinoma[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(04): 403-409.
[8] Zhaomin Zeng, Haiyan Yu. Clinical cognition of superfemale syndrome[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(02): 145-150.
[9] Quan Wei, Shen Zhang, Huijia Chen, Heng Zou, Lina Hu. Current research progress on correlation between female reproductive tract microbiota and assisted reproductive technology[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(02): 151-155.
[10] Yanyan Liu, Xi Tan, Xue Peng. Pregnancy complicated with papillary urothelial neoplasms of low malignant potential: a case report and literature review[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(02): 212-218.
[11] Shuang Dong, Xiaoying Li, Litao Sun, Jiawei Tian. Advances in the application of imaging techniques in preoperative staging of cervical cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(01): 113-119.
[12] Ouchan Hu, Zhongying Huang. Current status and outlook of research in treatment of unexplained recurrent spontaneous abortion[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(01): 16-22.
[13] Lifei Tian, Jianfeng Yao, Le Zhang, Yaqi Qu, Xiaolong Zhang, Pan Quan, Likun Yan. Application of deperitonealization of the round ligament in female inguinal hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(01): 56-59.
[14] Mi Li, huajuan Qiu, Yanqin Ji, Minghui Zhou. Effect of P16 and Ki67 expression and viral load detection on outcome of cervical lesions in woman of childbearing age with cervical intraepithelial neoplasia grade Ⅱ complicated with high-risk human papillomavirus infection[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(03): 272-278.
[15] Ying Liu, Man Yin, Linqing Yang, Yunfei Wang. Diagnostic characteristics of invasive stratified mucin-producing carcinoma and literature review[J]. Chinese Journal of Diagnostics(Electronic Edition), 2023, 11(03): 173-177.
Viewed
Full text


Abstract