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目的探讨肺癌细胞核的有关体视学参数在肺癌诊断分型方面的意义。方法收集肺癌外科手术切除标本70例及肺癌患者自身正常组织8例,分为鳞癌组(a)、腺癌组(b)、腺鳞癌组(c)、小细胞癌组(d)、大细胞癌组(e)及正常组(f)6组。每例随机切3个蜡块,HE染色,每张切片随机取3~4个视野,用Image-Pro图像分析软件对细胞核及细胞进行测试,按体视学公式计算以细胞为参照空间时细胞核的下列8项参数:体积密度(Vvn)、表面积密度(Svn)、表面积与体积比(Rsvn)、数密度(Nvn)、核浆比(Rnp)、平均体积(vn)、平均表面积(sn)及平均自由程(λn)。用SPSS11.5行方差分析和组间两两比较,并行逐步判别分析。结果Vvn、Svn、Nvn、vn、sn、λn、Rsvn及Rnp 8项参数在肺鳞癌、肺腺癌、肺腺鳞癌、肺大细胞癌、肺小细胞癌及正常对照组6组之间的方差分析中均有显著性差异。由Vvn、Svn、Nvn、vn、sn、λn、Rsvn及Rnp8项参数所建立的肺癌组与正常组的判别函数,肺癌组70例及正常组8例判别均正确;由Vvn、Svn、Rsvn、vn、、sn及λn六项参数所建立的不同类型肺癌及正常组的判别函数和由Vvn、Svn、sn及λn四项参数所建立的不同类型肺癌的判别函数,肺鳞癌和肺腺癌的准确度均为90%,判别6例肺小细胞癌均正确。结论1.在肺癌的判别方面,Vvn、Svn、Rsvn、Nvn、Rnp及λn6项参数对肺小细胞癌均是有判别能力的参数;Vvn、Nvn、vn、sn及Rsvn5项参数对肺鳞癌、肺腺癌、肺腺鳞癌及肺大细胞癌4组非小细胞肺癌均是有判别能力的参数;Rnp对肺鳞癌和肺腺癌是有判别能力的参数;2.在肺癌分型方面,Vvn、Svn、Nvn、λn及Vn均可做为区分肺小细胞癌与非小细胞肺癌的有意义参数;但仅依据肺癌细胞核的有关体视学参数很难对非小细胞肺癌组织学亚型进行满意分类;3.用Vvn、Svn、Nvn、vn、sn、λn、Rsvn及Rnp 8项参数对肺癌组与正常组进行判别,可获得满意的判别效果;用Vvn、Svn、sn及λn4项参数对肺鳞癌、肺腺癌、肺小细胞癌进行判别,可取得良好的判别效果。
Objective To investigate the significance of the relevant stereological parameters of lung cancer cell nuclei in the diagnosis of lung cancer. Methods Seventy lung cancer surgical specimens and eight normal lung tissues were collected and divided into squamous cell carcinoma group (a), adenocarcinoma group (b), adenosquamous carcinoma group (c), small cell carcinoma group (d) Large cell carcinoma (e) and normal group (f) 6 groups. Each sample was randomly divided into 3 sections and stained with HE. Each section was randomly selected from 3 to 4 fields. The nuclei and cells were tested with Image-Pro image analysis software. The cell nucleus was calculated according to the stereological formula (Vvn), surface area density (Svn), surface area to volume ratio (Rsvn), number density (Nvn), nuclear volume ratio (Rnp), average volume (vn), average surface area And mean free path (λn). With SPSS 11.5 line analysis of variance and comparison between groups, step by step parallel discriminant analysis. Results The parameters of Vvn, Svn, Nvn, vn, sn, λn, Rsvn and Rnp were significantly different between 6 groups of lung squamous cell carcinoma, lung adenocarcinoma, adenosquamous lung adenocarcinoma, pulmonary small cell carcinoma and normal control group Variance analysis showed significant differences. The discriminant function between the lung cancer group and the normal group established by the parameters of Vvn, Svn, Nvn, vn, sn, λn, Rsvn and Rnp8 was correct in 70 cases of lung cancer group and 8 cases in normal group. The discriminant function of Vvn, Svn, Rsvn, vn ,, sn and λn six different parameters of lung cancer and normal group to establish the discriminant function and the Vvn, Svn, sn and λn four parameters established by different types of lung cancer discriminant function, lung squamous cell carcinoma and lung adenocarcinoma The accuracy is 90%, 6 cases of small cell lung cancer are correct. In the discrimination of lung cancer, Vvn, Svn, Rsvn, Nvn, Rnp and λn6 parameters of lung small cell carcinoma are discriminative parameters; Vvn, Nvn, vn, sn and Rsvn5 parameters of lung squamous cell carcinoma , Lung adenocarcinoma, adenosquamous lung adenocarcinoma and pulmonary large cell lung cancer are all discriminant parameters; Rnp is a discriminative parameter for lung squamous cell carcinoma and lung adenocarcinoma; 2. In the classification of lung cancer In terms of Vvn, Svn, Nvn, λn and Vn, both can be used as a meaningful parameter for distinguishing small cell lung cancer from non-small cell lung cancer. However, it is very difficult to assess the histopathology of non-small cell lung cancer Subtypes were classified satisfactorily.3. Discrimination between lung cancer group and normal group by Vvn, Svn, Nvn, vn, sn, λn, Rsvn and Rnp parameters can get satisfactory discriminant effect; Vvn, Svn, sn and λn4 parameters of lung squamous cell carcinoma, lung adenocarcinoma, small cell lung cancer discrimination, can obtain a good discriminant effect.