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目的 探讨鼻咽脱落细胞进行DNA倍体和EB病毒编码RNA (EBERs)检测在鼻咽癌诊断中的应用。方法 对 38例经细胞学诊断为鼻咽癌和 8例为正常的鼻咽细胞涂片分别进行图像分析测定细胞DNA含量和EB病毒EBERs原位杂交检测。结果 与病理细胞学诊断相比 ,DNA异倍体分析和EBERs检测诊断癌的敏感性分别为 5 0 %和 92 %,其特异性均为 10 0 %;其阴性预测值分别为 30 %和 72 %。结论 与EBERs检测相比 ,DNA异倍体分析的诊断敏感性和阴性预测值较低 ,差异具有显著性 (分别为P <0 0 0 1和P <0 0 5 )。证明在鼻咽细胞学涂片应用EB病毒原位杂交检测诊断鼻咽癌优于应用DNA异倍体分析诊断。与细胞DNA图像分析相比 ,EB病毒原位杂交检测具有客观、实验条件简单等优点 ,在鼻咽癌可疑病人的早期诊断和鉴别诊断上具有重要的实用价值。
Objective To investigate the application of nasopharyngeal exfoliated cells in the detection of DNA ploidy and Epstein-Barr virus coding RNA (EBERs) in the diagnosis of nasopharyngeal carcinoma. Methods 38 cases of nasopharyngeal carcinoma diagnosed by cytology and 8 cases of normal nasopharyngeal smear were respectively analyzed by image analysis to detect the DNA content of cells and the detection of Epstein-Barr virus EBERs by in situ hybridization. Results Compared with pathological cytology, the sensitivity of DNA aneuploidy and EBERs in the diagnosis of cancer were 50% and 92% respectively, with a specificity of 100%, and the negative predictive value was 30% and 72% respectively %. Conclusion Compared with EBERs, the diagnostic sensitivity and negative predictive value of DNA aneuploidy are lower, with significant difference (P <0 01 and P 0 05, respectively). Proved in nasopharyngeal cytology smear application of Epstein-Barr virus in situ hybridization detection of nasopharyngeal carcinoma is better than the application of DNA aneuploidy diagnosis. Compared with the DNA image analysis, the detection of Epstein-Barr virus in situ hybridization has the advantages of objective and simple experimental conditions, and has important practical value in the early diagnosis and differential diagnosis of suspicious patients with nasopharyngeal carcinoma.