叶酸受体介导的 FRD 在宫颈上皮内瘤变和癌变诊断中的应用价值

摘要

Objective Methods To explore the application value of folate receptor mediated FRD in the diagnosis of cervical intraepithelial neoplasia and cancer.Method 2013 March to 2013 September,2528 outpatient and hospitalized patients with gynecological diseases from gynecological clinic were enrolled in this investigation.FRD staining was per-formed immediately after pelvic examination,cervical cell sampling and colposcopy partly performed,comparative analy-sis of three kinds of results by histopathologic diagnosis standard.Results 89 cases of positive staining were found and the positive rate was 3.52%.In terms of CIN I,CIN II,CIN III and cancer,the concordance rate of FRD staining with tissue pathological diagnosis was 66.7%(2/3),80.0%(4/5),50.0%(1/2)and 83.3%(5/6)respectively.Given that CIN II and CIN II + were abnormal cervical lesion,the sensitivity and specificity of FRD staining was 76.9% and 71.3%.Positive prediction rate was 28.6% and negative prediction rate was 95.4%.Conclusion FRD staining is a rapid,simple,accurate diagnosis method,has important clinical significance of cervical precancerous lesions,cervical can-cerearly detection.%目的：探讨叶酸受体介导的宫颈特殊染色法（FRD）在宫颈上皮内瘤变和癌变诊断中的应用价值。方法选择2013年3月-2013年6月来我院就诊的门诊及住院妇科疾病患者，在征得其同意后行 FRD 染色检查宫颈病变，共检查患者2528例。对其中的部分患者行细胞学检查，部分患者行阴道镜检查，以组织病理学结果为诊断标准，对三种检查结果进行对比分析。结果特殊染色发现异常89例，阳性率为3．52％，组织病理学结果与宫颈特殊染色的诊断符合率依次为：CINI 为66．7％（2/3），CIN II 为80．0％（4/5），CIN III 为50．0％（1/2），宫颈癌83．3％（5/6）。以组织病理学 CIN II 为标准，宫颈特殊染色的敏感性为76．9％，特异性为71．3％，阳性预测值为28．6％，阴性预测值为95．4％。结论FRD 宫颈特殊染色法是一种快速、简便、准确的诊断方法，对早期发现宫颈癌前病变、宫颈癌具有重要的临床意义。