探讨全自动DNA-ICM对浆膜腔积液细胞学的辅助诊断价值  

Explore automatic DNA-ICM auxiliary diagnostic value in liquid-based preparation-processed serous effusion samples

作　　者：赵焕[1] 郭会芹[1] 李华 曹箭[1] 周彬[1] 

机构地区：[1]中国医学科学院肿瘤医院病理科细胞学室,北京100021 [2]武汉兰丁肿瘤早期诊断检测中心,湖北武汉430050

出　　处：《中国医刊》2015年第3期57-59,共3页Chinese Journal of Medicine

基　　金：北京希望马拉松专项基金(LC2011B22)

摘　　要：目的浆膜腔积液细胞学诊断常遇到异常细胞数量少或细胞形态不典型的病例,导致诊断困难。本研究探讨DNA-ICM对浆膜腔积液细胞学辅助诊断的作用。方法选取浆膜腔积液200例,液基制片剩余标本进行DNA-ICM分析,并与细胞学和临床资料对比分析。结果 DNA-ICM制片满意标本167例,有明确诊断的143例(恶性肿瘤126例,良性病变17例)纳入检测。细胞学和DNA-ICM的敏感性分别为73%和46%(P=0.0001),特异性均为100%。细胞学诊断可疑癌的14例恶性病例中,1例DNA-ICM阳性。结论在浆膜腔积液诊断中,DNA-ICM的敏感性低于细胞学,但该方法特异性好,对细胞学诊断不明确的病例可能有辅助诊断作用。Objective The cytologic diagnosis of serous effusion samples often encounter the cases with less number of abnormal cells or untypical morphology, which may cause diagnostic difficulties. It was reported that automatic DNA-ICM system can analyze the characteristics of the cell nucleus and assist cytologic diagnosis. The purpose of this study is to analyze the serous effusion specimens using DNA-ICM and explore the role for assisting cytological diagnosis. Method We collected 200 cases of the remaining serous effusion samples after being prepared for the liq-uid based cytology. It was used for the analysis of DNA-ICM. The result of DNA-ICM was compared with cytologic diagnosis and clinical prognosis respectively. Cytologic diagnosis and DNA-ICM analysis were performed double blindly. Result The 167 cases were eligible for DNA-ICM analysis. Of these cases, 143 cases with clinical follow-up data and diagnoses （126 cases of malignant tumor, 17 cases of benign lesions） were included in this study. The sensitivity of cytological diagnosis for malignant tumor was 73%. And the sensitivity of DNA-ICM for malignant tumor was 46%, which was lower than that of cytologic diagnosis. The specificity of two methods was both 100%. In 14 patients with suspected carcinoma diagnosis by cytology, 1 case was positive for DNA analysis, the result was lung adenocarcinoma in histopathology. Conclusion For remain samples after liquid-based preparation of the serous effusions, the sensitivity of DNA-ICM is lower than that of cytology. But this method has good specificity, which may have auxiliary diagnostic role on ambiguous cases of cytology.

关 键 词：浆膜腔积液 全自动DNA图像分析 液基细胞学 

分 类 号：R446.1[医药卫生—诊断学]