本文選題：DNA倍體分析　切入點：宮頸上皮內瘤變　出處：《首都醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討DNA倍體分析在宮頸上皮內瘤變病情監(jiān)測中的應用價值。方法:選擇首都醫(yī)科大學附屬北京友誼醫(yī)院婦產科2015年4月至2015年12月經陰道鏡活檢病理診斷為宮頸上皮內瘤變的患者84例及經陰道鏡活檢病理診斷為宮頸慢性炎癥的患者30例,治療后6個月、12個月進行隨訪觀察。對納入研究的患者治療前、治療后6個月、治療后12個月復查時均行宮頸HR-HPV、陰道鏡活檢及DNA倍體分析檢測。監(jiān)測治療前后宮頸病變的殘留或復發(fā),從而為指導臨床治療,探索更有效的宮頸病變治療后隨診方案。結果:1、隨著宮頸病變程度的增加,HR-HPV陽性率及DNA倍體分析檢測陽性率也隨之增加。DNA異倍體細胞數隨宮頸病變程度升高呈正相關遞增關系。2、手術治療后6個月、12個月復查時宮頸病變程度、HR-HPV陽性率、DNA倍體分析陽性率較前均有顯著降低。3、治療前84例CIN患者中,有78例HR-HPV感染病例,其中45例伴有DNA倍體分析陽性。治療后6個月復查有10例HR-HPV持續(xù)感染病例,其中7例伴有DNA倍體分析陽性。治療后12個月復查有5例HR-HPV持續(xù)感染病例,其中4例伴有DNA倍體分析陽性。4、合并HR-HPV感染的ASCUS患者,DNA倍體陽性預測CIN II以上宮頸病變的靈敏度為96.43%。結論:1、HR-HPV感染率、DNA倍體分析陽性率及DNA異倍體細胞數隨宮頸病變級別升高呈上升趨勢。2、手術治療能有效降低宮頸病變程度、降低HR-HPV陽性率及DNA倍體檢測陽性率。3、合并HR-HPV持續(xù)感染的CIN患者中,同時行DNA倍體分析檢測可提高診斷的敏感度,降低漏診率,可輔助預測宮頸病變的進展情況,較好的監(jiān)測宮頸病變的預后情況。4、DNA倍體分析在HR-HPV感染的ASCUS患者的分流診治中有較高的臨床應用價值,有助于早發(fā)現和早治療。
[Abstract]:Objective: to evaluate the value of DNA ploidy analysis in monitoring cervical intraepithelial neoplasia. Methods: the pathological diagnosis of gynecology and obstetrics department of Beijing Friendship Hospital affiliated to Capital Medical University from April 2015 to 2015 was selected. 84 cases of cervical intraepithelial neoplasia and 30 cases of chronic cervix inflammation diagnosed by colposcopy biopsy were studied. 6 months and 12 months after treatment, the patients who were included in the study were followed up for 6 months before and 6 months after treatment. HR-HPVP, colposcopy biopsy and DNA ploidy analysis were performed 12 months after treatment. The residual or recurrence of cervical lesions was monitored before and after treatment, so as to guide clinical treatment. Results the positive rate of HR-HPV and the positive rate of DNA ploidy analysis also increased with the increase of cervical lesion degree. The number of DNA aneuploidy cells increased positively with the degree of cervical lesion. The positive rate of HR-HPV and the positive rate of DNA ploidy in HR-HPV were significantly lower than those before operation. The positive rate of HR-HPV and DNA ploidy in 84 patients with CIN before treatment were significantly lower than those before treatment. There were 78 cases of HR-HPV infection, of which 45 cases were positive for DNA ploidy analysis, 10 cases were HR-HPV persistent infection after 6 months of treatment, 7 cases were positive for DNA ploidy analysis, and 5 cases were HR-HPV persistent infection at 12 months after treatment. Among them, 4 cases with DNA ploidy analysis were positive. The sensitivity of ASCUS patients with HR-HPV infection in predicting cervical lesions above CIN II was 96.43. Conclusion the positive rate of DNA ploidy analysis and the number of DNA aneuploidy cells in the patients with HR-HPV infection are 96.433.Conclusion the positive rate of ASCUS ploidy analysis and the number of DNA aneuploidy cells are correlated with cervical diseases. The increase of grade of change shows an upward trend. The surgical treatment can effectively reduce the degree of cervical lesions. To reduce the positive rate of HR-HPV and the positive rate of DNA ploidy. In CIN patients with persistent infection of HR-HPV, DNA ploidy analysis at the same time can improve the sensitivity of diagnosis, reduce the rate of missed diagnosis, and can help to predict the progress of cervical lesions. Better monitoring the prognosis of cervical lesions .4DNA ploidy analysis has a high clinical value in the diagnosis and treatment of ASCUS patients with HR-HPV infection, which is helpful for early detection and treatment.
【學位授予單位】：首都醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.33

【參考文獻】

相關期刊論文 前10條

1 劉阿林;高金瑜;;DNA倍體定量分析和HPV分型檢測對宮頸病變的診斷價值[J];江蘇醫(yī)藥;2017年04期

2 馬麗麗;陳敏;王心;尚麗新;;TCT、DNA倍體定量分析及HPV檢測篩查宮頸病變價值研究[J];人民軍醫(yī);2017年01期

3 周暉;劉昀昀;林仲秋;;《2017 NCCN宮頸癌臨床實踐指南》解讀[J];中國實用婦科與產科雜志;2017年01期

4 梁明旋;周桂桃;曹曉峰;;DNA倍體分析聯合高危型HPV檢測對宮頸癌的篩查效果觀察[J];吉林醫(yī)學;2016年12期

5 宋文惠;王麗;馮莉;崔文華;米冬青;于湄;;DNA倍體分析對HPV陰性的ASCUS宮頸上皮內瘤變的診斷價值研究[J];臨床誤診誤治;2016年10期

6 蔣秋敏;謝凱圣;;DNA倍體分析聯合電子陰道鏡在宮頸癌篩查中的臨床價值[J];中國現代醫(yī)藥雜志;2016年04期

7 徐靈;徐軍;陶敏芳;;DNA異倍體定量檢測用于高危型HPV感染婦女分流診治的臨床價值[J];臨床和實驗醫(yī)學雜志;2016年08期

8 陽艷;段潔;黃燕明;郎雁;王燕;;DNA倍體分析和液基細胞學在宮頸病變早期篩查中的應用[J];實用預防醫(yī)學;2016年04期

9 馮曉杰;馬一鳴;王莉;;DNA倍體及MDR1與宮頸癌新輔助化療耐藥相關性分析[J];中華腫瘤防治雜志;2015年23期

10 唐緒明;田玉生;鄒顏陽;馮強;;宮頸細胞DNA倍體分析在臨床上的應用[J];深圳中西醫(yī)結合雜志;2015年19期

，

本文編號：1562034