食管黏膜脱落细胞DNA倍体检测在食管癌诊断中的价值  

The diagnostic significance of DNA ploidy analysis in esophageal mucosal shedding cells for esophagus carcinoma

作　　者：王丽萍[1] 马俊[1] 梁若玲[1] 江浩[2] 李静娴[1] 蔡丽逢[1] 

机构地区：[1]广东省佛山市第二人民医院消化内科,2528000 [2]广东省佛山市第二人民医院病理科,2528000

出　　处：《广东医学》2013年第16期2471-2474,共4页Guangdong Medical Journal

基　　金：广东省佛山市科技局医学类科技攻关项目(编号:201108008)

摘　　要：目的探讨胃镜直视下食管病灶脱落黏膜细胞的DNA倍体分析对食管良恶性疾病的诊断价值。方法采用Feulgen染色及图像分析技术,对胃镜直视下刷取的食管病灶黏膜细胞进行DNA含量及倍体分析,以黏膜病理组织镜下诊断结果为"金标准",分析食管病灶黏膜细胞DNA倍体分析对食管良恶性疾病的诊断价值。结果对病理诊断为食管癌43例,良性病变61例分析发现,食管癌中有34例DNA倍体异常,良性病变中有4例DNA倍体异常,其诊断食管癌灵敏度为79.07%,特异度为93.44%,阳性预测值为89.47%,阴性预测值为86.36%,阳性似然比为12.05,Youden指数为72.51%。食管癌患者的黏膜脱落细胞DNA的倍体阳性率明显高于食管良性疾病患者;在食管癌患者中,分化程度越低DNA倍体的含量越高,DNA倍体的含量与食管癌的分化程度有一定关系。结论食管黏膜脱落细胞DNA倍体对食管癌的诊断有一定价值,为大规模开展食管脱落细胞进行分子普查奠定了基础。Objective To investigate the diagnostic significance of DNA ploidy analysis in the exfoliated cell of esophageal lesions for esophagus carcinoma（EC）.Methods The mucous cells of oesophagopathy lesion were mopped and collected directly under gastroscopy.The DNA content and ploid were assessed by Feulgen staining and image analysis.The mocosal pathological diagnosis with gastroscopy was applied as the golden standard for EC.Results Forty three cases of EC and 61 cases with benign lesions were pathologically proved;among whom 34 cases with DNA ploidy abnormality were found in EC patients,whereas 4 cases with DNA ploidy abnormality were found in benign lesions.The sensitivity,specificity,positive predictive value,negative predictive value,likelihood ratio and Youden index of DNA ploidy abnormality for EC were 79.07%,93.44%,89.47%,86.36%,12.05 and 72.51%,respectively.The positive rate of DNA ploidy abnormality in EC patients was significantly higher than controls.In the EC patients,the low differentiation was correlated with DNA ploidy abnormality.Conclusion The DNA ploidy analysis in the exfoliated esophageal cells provides diagnostic value for EC,supporting large-scale screen for EC.

关 键 词：食管癌 DNA倍体 FEULGEN染色 

分 类 号：R730.4[医药卫生—肿瘤]