本文選題：DNA倍體分析　切入點(diǎn)：宮頸上皮內(nèi)瘤變　出處：《首都醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:探討DNA倍體分析在宮頸上皮內(nèi)瘤變病情監(jiān)測(cè)中的應(yīng)用價(jià)值。方法:選擇首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院婦產(chǎn)科2015年4月至2015年12月經(jīng)陰道鏡活檢病理診斷為宮頸上皮內(nèi)瘤變的患者84例及經(jīng)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(gè)月、12個(gè)月進(jìn)行隨訪觀察。對(duì)納入研究的患者治療前、治療后6個(gè)月、治療后12個(gè)月復(fù)查時(shí)均行宮頸HR-HPV、陰道鏡活檢及DNA倍體分析檢測(cè)。監(jiān)測(cè)治療前后宮頸病變的殘留或復(fù)發(fā),從而為指導(dǎo)臨床治療,探索更有效的宮頸病變治療后隨診方案。結(jié)果:1、隨著宮頸病變程度的增加,HR-HPV陽(yáng)性率及DNA倍體分析檢測(cè)陽(yáng)性率也隨之增加。DNA異倍體細(xì)胞數(shù)隨宮頸病變程度升高呈正相關(guān)遞增關(guān)系。2、手術(shù)治療后6個(gè)月、12個(gè)月復(fù)查時(shí)宮頸病變程度、HR-HPV陽(yáng)性率、DNA倍體分析陽(yáng)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(yáng)性。治療后6個(gè)月復(fù)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(yáng)性。治療后12個(gè)月復(fù)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(yáng)性。4、合并HR-HPV感染的ASCUS患者,DNA倍體陽(yáng)性預(yù)測(cè)CIN II以上宮頸病變的靈敏度為96.43%。結(jié)論:1、HR-HPV感染率、DNA倍體分析陽(yáng)性率及DNA異倍體細(xì)胞數(shù)隨宮頸病變級(jí)別升高呈上升趨勢(shì)。2、手術(shù)治療能有效降低宮頸病變程度、降低HR-HPV陽(yáng)性率及DNA倍體檢測(cè)陽(yáng)性率。3、合并HR-HPV持續(xù)感染的CIN患者中,同時(shí)行DNA倍體分析檢測(cè)可提高診斷的敏感度,降低漏診率,可輔助預(yù)測(cè)宮頸病變的進(jìn)展情況,較好的監(jiān)測(cè)宮頸病變的預(yù)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(yīng)用價(jià)值,有助于早發(fā)現(xiàn)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(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R737.33

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