Bi Xin-Yi, Pan Zheng-Wu, Liu Shu-Lan, Chen Xiao-Ming, Li Jin, Bu Qing-Feng, Zuo Ming-Li, Wang Jia, Sun Wen-Ping, Zhang Yan, Liu Wei, Wang Fei, Li Chang-Zhong
School of Clinical Medicine, Hebei University, Baoding, Hebei, China.
Peking University People's Hospital, Beijing, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40038. doi: 10.1097/MD.0000000000040038.
The present study aimed to evaluate the application of DNA ploidy analysis, human papillomavirus (HPV-DNA) test, and thin-prep cytologic test (TCT) for mass screening of cervical cancer (CC). A total of 13,830 patients who underwent both TCT and HPV-DNA tests from June 2021 to June 2022 were selected as study participants (10,107 patients from Shandong Provincial Hospital, 2447 patients from First People's Hospital of Tancheng County, and 1276 patients from Liaocheng People's Hospital). We also conducted a DNA ploidy analysis and compared the results. A biopsy was performed by colposcopy according to the screening results, and the diagnosis based on the results of the biopsy was regarded as "the golden standard." The χ2 test was used for group comparison, the Kruskal-Wallis test was used for ordinal data, and the Kappa test was used for consistency analysis. Based on the retrospective analysis of the biopsy results, DNA ploidy analysis, and TCT combined with HPV-DNA test, the accuracy of predicting precancerous cervical lesion was 97.95%, the positive predictive value was 66.72%, and the negative predictive value was 97.30%. The comprehensive detection showed a similar outcome as that for histopathological examination. The study demonstrates that DNA ploidy analysis, when used in conjunction with the HPV-DNA test and TCT, significantly enhances the accuracy of CC screening. DNA ploidy analysis provides a reliable basis for the early detection and accurate prediction of precancerous cervical lesions, supporting its integration into routine CC screening protocols.
本研究旨在评估DNA倍体分析、人乳头瘤病毒（HPV-DNA）检测和薄层液基细胞学检测（TCT）在宫颈癌（CC）大规模筛查中的应用。选取2021年6月至2022年6月期间同时接受TCT和HPV-DNA检测的13830例患者作为研究对象（山东省立医院10107例、郯城县第一人民医院2447例、聊城市人民医院1276例）。我们还进行了DNA倍体分析并比较结果。根据筛查结果通过阴道镜进行活检，将基于活检结果的诊断视为“金标准”。采用χ2检验进行组间比较，Kruskal-Wallis检验用于有序数据，Kappa检验用于一致性分析。基于对活检结果、DNA倍体分析以及TCT联合HPV-DNA检测的回顾性分析，预测宫颈病变前状态的准确率为97.95%，阳性预测值为66.72%，阴性预测值为97.30%。综合检测结果与组织病理学检查相似。该研究表明，DNA倍体分析与HPV-DNA检测和TCT联合使用时，可显著提高宫颈癌筛查的准确性。DNA倍体分析为宫颈病变前状态的早期检测和准确预测提供了可靠依据，支持将其纳入常规宫颈癌筛查方案。
