Application Value of Quantitative Analysis of Cell DNA in Cervical Lesion Screening / 中国医科大学学报

ABSTRACT

Objective To determine the application value of quantitative detection of DNA in cervical lesion screening.Methods Retrospective analysis of 82 518 cases of cervical lesions was carried out.The sensitivity,specificity,positive predictive value (PPV),and negative predictive value (NPV) of DNA quantification and ThinPrep cytology test (TCT) for the diagnosis of cervical lesions were compared with the results of biopsy.The accuracy of the two methods was evaluated by applying the receiver operating characteristic curve.Results The sensitivity of DNA quantification,TCT,and combined diagnosis was 77.37％,70.97％,and 90.24％,respectively,and the specificity was 65.59％,70.42％,and 45.06％,respectively.The sensitivity of cell DNA quantitative analysis was higher but the specificity was lower than that of TCT,while the sensitivity of combined diagnosis was the highest.In DNA quantitative analysis of patients with and without atypical squamous cells of undetermined significance (ASCUS),the positive rates of pathology were 42.71％ and 12.5％,respectively.The misdiagnosis rate of cell DNA quantitative analysis for screening cervical adenocarcinoma (39.13％) was higher than that for screening cervical squamous cell carcinoma (15.11％).In a cytologic smear,the misdiagnosis rate of cells ＜ 5 000 (57.83％) was much higher than that of cells ＞ 5 000 (22.63％).However,a combined diagnosis with TCT could reduce the misdiagnosis rate from 20.19％ to 13.38％.Conclusion Cell DNA quantification is more sensitive than TCT,but the specificity of cell DNA analysis is lower than that of TCT,and the screening rate for cervical adenocarcinoma is high.Quantitative DNA analysis combined with TCT can significantly improve the screening sensitivity.