Objective: The objective of this study was to evaluate the application of DNA ploidy analysis in large-scale population screening for cervical cancer. Methods: From March 2016 to March 2019, eligible subjects were enrolled and recommended to undergo DNA ploidy analysis, the ThinPrep cytology test (TCT), and high-risk human papillomavirus (hrHPV) detection concurrently. Patients with positive results were recommended for colposcopy, and biopsy diagnosis was regarded as the “gold standard.” We compared the test efficiencies of the 3 methods and compared the efficiency and accuracy of the TCT in our hospital and the “2-cancer screening” project in Hubei Province during the same period. Results: Among 20,574 women, the positive rates of DNA ploidy analysis, cytology, and hrHPV testing were 4.01%, 4.71%, and 16.28%, respectively. The sensitivities of these methods for screening for grade 2+ cervical intraepithelial neoplasia were 0.70, 0.68, and 0.96, and their specificities were 0.79, 0.82, and 0.45, respectively. On comparing DNA ploidy analysis with the TCT, there was no significant difference in the sensitivity, specificity, positive predictive value, negative predictive value, and missed diagnosis rate. In opportunistic screening and the 2-cancer screening project, the positive rates of cytology were 4.71% and 2.87%, respectively. And the efficiency and accuracy of the TCT in opportunistic screening were higher than in the 2-cancer screening project. Conclusion: Therefore, DNA ploidy analysis, which is of low-cost and does not depend on cytopathologists, can replace cytology and be applied in large-scale population screening for cervical cancer.
Acta Cytologica

中文翻译：

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DNA倍体分析在大规模人群宫颈癌筛查中的应用

目的：本研究的目的是评估DNA倍体分析在大规模人群宫颈癌筛查中的应用。方法： 2016年3月至2019年3月，纳入符合条件的受试者，建议同时进行DNA倍体分析、ThinPrep细胞学检测（TCT）和高危人乳头瘤病毒（hrHPV）检测。结果呈阳性的患者被推荐进行阴道镜检查，活检诊断被视为“金标准”。我们比较了3种方法的检测效率，并比较了我院TCT与同期湖北省“两癌筛查”项目的效率和准确性。结果： 20574名女性中，DNA倍体分析、细胞学和hrHPV检测的阳性率分别为4.01%、4.71%和16.28%。这些方法筛查 2+ 级宫颈上皮内瘤变的敏感性分别为 0.70、0.68 和 0.96，特异性分别为 0.79、0.82 和 0.45。将DNA倍体分析与TCT进行比较，其敏感性、特异性、阳性预测值、阴性预测值和漏诊率均无显着差异。机会性筛查和二癌筛查项目中，细胞学阳性率分别为4.71%和2.87%。TCT在机会性筛查中的效率和准确性高于2种癌症筛查项目。结论：因此，低成本、不依赖细胞病理学家的DNA倍体分析可以替代细胞学，应用于大规模人群宫颈癌筛查。
细胞学学报