论文部分内容阅读
目的探讨DNA定量检测在胸水肺癌细胞病理学诊断中的应用价值,并为肺癌伴胸水病例选择性扩大手术指征提供依据。方法我院临床诊断为肺癌伴胸水的患者50例,制备常规胸水涂片,进行改良FeulgenDNA染色,应用2000型癌细胞定量检测系统测定DNA主峰质量、平均DNA质量、DNA指数(DI)、DNA倍体类型和细胞周期等参数。结果本组患者病理学诊断均为腺癌,78%(39/50例)在胸水中找到癌细胞,其中8例原先诊断为核异型,通过DNA测定确诊,阳性率提高16%。常规细胞病理阳性率为62%,灵敏度为79.5%,特异度为100%;DNA定量检测阳性率为78%,灵敏度及特异度均为100%(χ2=6.13,P<0.05)。癌细胞阳性组平均DNA质量为(18.29±1.48)pg,DI为1.45±0.35,5倍体超过率为(6.00±10.54)%;癌细胞阴性组平均DNA质量为(7.03±1.75)pg,DI为0.83±0.15,5倍体超过率为(0.12±0.29)%;两组的差异均有显著性(P<0.05)。结论胸水细胞DNA检测有助于提高肺癌细胞病理学阳性率,可为渗出性胸水(无癌细胞)的病例选择性扩大手术指征提供依据。
Objective To investigate the value of DNA quantitative detection in pathological diagnosis of pleural effusion and lung cancer, and to provide a basis for the selective augmentation of surgical indications in patients with lung cancer and pleural effusion. Methods Fifty patients with lung cancer with pleural effusion were diagnosed in our hospital, and routine pleural fluid smears were prepared for improved FeulgenDNA staining. The quality of DNA peak, average DNA quality, DNA index (DI) and DNA times Body type and cell cycle parameters. Results The pathological diagnosis of this group was adenocarcinoma. 78% (39/50) of them found cancer cells in pleural effusion. Eight of them were initially diagnosed as nuclear atypia, and the positive rate was 16% confirmed by DNA test. The positive rate of routine cytopathology was 62%, the sensitivity was 79.5% and the specificity was 100%. The positive rate of DNA was 78% and the sensitivity and specificity were both 100% (χ2 = 6.13, P <0.05). The average DNA quality of cancer cell positive group was (18.29 ± 1.48) pg, DI was 1.45 ± 0.35, and the rate of ploidy was (6.00 ± 10.54)%. The average DNA quality of cancer cell negative group was (7.03 ± 1.75) pg, DI (0.12 ± 0.29)% respectively. There was significant difference between the two groups (P <0.05). Conclusion Detection of DNA in pleural effusion cells helps to improve the positive rate of lung cancer cell pathology, which may provide evidence for the selective expansion of surgical indications for exudative pleural effusion (no cancer cells).