Application Value Of DNA Quantitative Cytology Combined With Cervical Liquid-based Cytology In Cervical Lesions

Objective: To explore the application value of DNA quantitative cytology combined with cervical liquid-based cytology in cervical lesions in Qinghai Province.Methods: 2475 cases of patients were enrolled in this study, all of whom were screened by cervical liquid-based cytology with DNA quantitative cytology in inpatient and outpatient of Department of Gynecology of Qinghai University Affiliated hospital between January 2013 and December 2014. 194 patients showed positive results of cervical liquid-based cytology and/or DNA quantitative cytology, and were given colposcopy and histopathological examination, with histopathological examination as the gold standard.Results: In TCT detection, with ≥ASCUS as the standard for biopsy, the sensitivity of CINII+ was found of 73.49% while specificity of 67.57%. In DNA quantitative cytology, with ≥3 heteroploid cells as the standard for biopsy, the sensitivity of CINII+ was 83.13%. There were statistically significant differences between the two methods. In DNA quantitative cytology, with 1-2 heteroploid cells as the standard for biopsy, the sensitivity of CINI+ was 92.24% and the specificity was 52.56%; while with ≥3 heteroploid cells as the standard for biopsy, the sensitivity of CINI+ was 77.59% and the specificity was 74.36%. There significant differences between the two standards in sensitivity and specificity separately. Positive detection rate of CINII+ with 1-2 heteroploid cells as the standard for biopsy was 29.41%, while with ≥3 heteroploid cells as the standard for biopsy was 62.73%, and there were statistically significant differences. When no heteroploid cells, 1-2 heteroploid cells or ≥3 heteroploid cells were seen in DNA quantitative cytology, the corresponding positive rates of TCT testing were0.94%,41.18%and94.54%. There were no statistically significant differences in pairwise comparison. The positive predictive values of TCT, DNA quantitative cytology, and DNA quantitative cytology + TCT were 95.56%, 81.82%and 63.57%. There were statistically significant differences in pairwise comparison. Diagnose accordance rates were 59.79%, 76.29% and 82.47% respectively. Positive rates of HPV was 90.36% in ≥CINII group while 71.17% in≤CINIgroup. There were statistically significant differences between the two groups.Conclusion: DNA quantitative cytology has higher sensitivity than TCT in screening high level cervical lesions. With the increase of DNA heteroploid cells, detection rate of high level cervical lesion is increased. Positive results in both DNA quantitative cytology and cervical liquid-based have a higher positive predictive value, and the diagnose accordance rate is high. The combined screening is better than single screening. Positive predictive value of TCT increases as the number DNA heteroploid cells increases. Positive rate of high-risk type HPV is higher in high level cervical lesions than that of low-risk cervical lesions.