支气管镜活检小标本检测DNA含量对肺癌的诊断价值  

Diagnostic value of detection of DNA content in small biopsy specimens of lung cancer

作　　者：马经平[1] 龚建化[1] 黄河[1] 谢凡[1] 赵秀香[1] 张家洪[1] 李琳芸[2] 王昌富[2] 

机构地区：[1]荆州市中心医院呼吸内科,湖北荆州434020 [2]荆州市中心医院检验科,湖北荆州434020

出　　处：《临床荟萃》2007年第19期1375-1377,共3页Clinical Focus

摘　　要：目的探讨流式细胞仪检测纤维支气管镜活检小标本DNA含量对支气管肺癌的诊断价值。方法36例肺癌,23例肺部良性病变患者,经纤维支气管镜获取小标本,应用流式细胞仪(FCM)对经纤维支气管镜活检的小标本DNA含量(DI)、DNA合成期(S)细胞比率(SPF)、细胞增殖指数(PI)测定后进行分析,并与细胞刷检、小标本病理检查结果相比较。结果36例支气管肺癌组织DNA含量DI均值1.18±0.32,异倍体率72.22%,S期细胞比率8.71%,增殖指数11.78%;23例良性病变组织DI均值1.0±0.08,异倍体率4.30%,S期细胞比率4.41%,增殖指数4.91%;肺癌组与良性病变组比较DI值明显升高(P<0.05)、异倍体率增多(P<0.01)、SPF增大(P<0.01)、PI增加(P<0.01),差异均有统计学意义;刷片细胞学检查癌细胞阳性16例,阳性率44.40%,DNA含量倍体分析阳性26例,阳性率72.22%,组织病理检查阳性29例,阳性率80.55%,DNA倍体分析结合病理检查出阳性率为88.88%。结论应用FCM检测经纤支镜活检小标本的细胞DNA含量,对肺癌的诊断有一定的价值,联合其他检查可提高肺癌的诊断率。Objective To study the value of detection of DNA content in small biopsy specimens through fiber bronchoscope by flow cytometry （FCM） in diagnosis of bronchogenic carcinoma. Methods Fifty-nine small transbronchial biopsy specimens including 36 cases of bronchogenic carcinoma and 23 cases of benign pulmonary disease were examined for DNA content and S phase fraction（SPF） and proliferative index（PI） by FCM. The results were compared with those of brush biopsy and pathological examination. Results In tissues of 36 bronchogenic carcinoma, DNA index（DI） was 1.18±0.32,the frequency of aneuploid was 72.22% ,SPF was 8.71% ,PI was 11.78% In tissues of 23 benign pulmonary disease,DI was 1.0±0.08,the frequency of aneuploid was 4. 30% ,SPF was 4.41% ,PI was 4.91%. DI,PI,SPF and the frequency of aneuploid in lung cancer were higher than those of benign group（ P〈0.01）. In lung cancer, for brush cytological examination, the positive rate of cancer cell was 44.40% （16/36）, for DNA ploidy analysis,the positive rate was 72.22% （26/36） and for pathology,the positive rate of tumor was 80.55% （29/36）. The diagnostic positive rate was 88.88% through DNA ploidy analysis combined with pathological test. Conclusion Detection of DNA content of small transbronchial biopsy specimens by FCM is of clinical value in diagnosis of lung cancer. This kind of test combined with other tests can increase diagnosis rate of lung cancer.

关 键 词：肺肿瘤 支气管镜 流式细胞术 脱氧核糖核酸酶(嘧啶二聚体) 

分 类 号：R563[医药卫生—呼吸系统]