液基细胞学结合DNA定量分析鉴别诊断胸腹水良恶性细胞的应用  

Application of liquid base cytology test combined with automated DNA imaging cytometry in differential diagnosis of benign and malignant cell in smear of pleural effusion and ascites

作　　者：黄卫彤[1] 覃志坚[1] 黄燕[1] 韦莹慧[1] 赵娜[1] 唐玉连[1] 

机构地区：[1]右江民族医学院附属医院检验科,广西百色533000

出　　处：《临床医学》2009年第12期25-26,F0004,共3页Clinical Medicine

摘　　要：目的探讨液基细胞学结合DNA定量分析鉴别诊断浆膜腔积液良恶性细胞的应用价值。方法收集297例(包括179例恶性、118例炎性,均经临床或病理诊断证实)胸腹水标本,每例标本采用液基细胞技术制成3张薄层细胞片,2张细胞片做H-E染色,用于细胞学检查;另1张经Feulgen-Thionin染色,应用SPICM-DNA全自动细胞图象分析系统方法进行细胞核DNA定量测定。结果液基细胞学方法对恶性和炎性胸腹水的诊断阳性率分别为82.7%(148/179)、83.9%(99/118),AICM的诊断阳性率分别为97.2%(174/179)、100%(118/118)。在癌性胸腹水检测中,SPICM-DNA全自动细胞图象分析系统可检出数量不等的DI>2.5异倍体细胞,而炎性胸腹水不能检出该类细胞。两种方法结合对恶性胸腹水的阳性诊断率为98.3%(177/179)。结论液基细胞学结合DNA定量分析用于胸腹水良性与恶性细胞的鉴别诊断较细胞学方法敏感,不但能避免漏诊,还可对恶性细胞分型诊断。Objective To investigate the application value of liquid base cytology test combined with automated DNA imaging cytometry in differential diagnosis of benign and malignant cell in smear of pleural effusion and ascites（PEA）. Methods In 297 samples of PEA（ 179 cases were classified as benign and other 118 cases as malignant by clinic or pathology） , cells of PEA were spun on three slides by liquid bas, cytology technique in eaeh sample. Two slides were stained by H - E method for cytology analysis, and other one slide was stained with Feulgen method for detection of DNA content by automatic imaging cytometer（AICM）. Results Liquid base cytological iavestigation showed 82.7% （148/179） sensitivity for malignant and 83.9% （99/118）sensitivity for benign effusions ,while DNA imaging analysis revealed 97.2% （ 174/179 ）sensitivity for malignant and 100% （ 118/118 ） sensitivity for benign effusions respectively. Liquid base cytology test combined with automated DNA imaging cytometry showed 98.9% （177/179） sensitivity for malignant effusions. Conclusion Liquid base cytology test combined with automated DNA imaging cytometry can be used to differentially diagnose benign and malignant pleural effusion and aseites more objective and sensitive than cytological methods.

关 键 词：胸腹水 全自动细胞图像分析系统 液基细胞学 鉴别诊断 

分 类 号：R730.4[医药卫生—肿瘤] R446.8[医药卫生—临床医学]