细胞DNA定量分析技术在肺癌诊断中的应用价值  

Application of DNA.image cytometry in the diagnosis of lung cancer

作　　者：陶伟[1] 李俊[1] 程柳柳[1] 

机构地区：[1]安徽医科大学第一附属医院肿瘤内科,合肥230022

出　　处：《中华肿瘤杂志》2016年第2期113-117,共5页Chinese Journal of Oncology

基　　金：卫生部医药卫生科技发展研究项目（W2013GJ42）

摘　　要：目的探讨细胞DNA定量分析（DNA—ICM）在肺癌诊断中的应用价值。方法收集216例肺癌和209例非肺癌患者的支气管肺泡灌洗液（BALF）和（或）纤维支气管镜刷片标本532个，其中肺癌标本289个，非肺癌标本243个，分别进行DNA．ICM和液基细胞学（LBC）检查，并将结果进行比较。结果DNA—ICM检查的敏感度为69．2％，特异度为100．0％；LBC检查的敏感度为46．7％，特异度为97．9％；DNA-ICM检查的敏感度高于LBC（P〈0．01）。BALF中，DNA—ICM检查的敏感度为71．9％，特异度为100．0％；LBC检查的敏感度为48．2％，特异度为98．5％。纤维支气管镜刷片标本中，DNA-ICM检查的敏感度为62．8％，特异度为100．0％；LBC检查的敏感度为43．0％，特异度为95．3％。与LBC检查比较，BALF和纤维支气管镜刷片标本的DNA．ICM检查敏感度均较高（P〈0．01）。107例同时采集BALF和纤维支气管镜刷片标本的患者中，BALF的DNA—ICM检查敏感度为79．7％，纤维支气管镜刷片标本的DNA—ICM检查敏感度为60．8％，差异有统计学意义（P〈0．05）。在不同组织分型的肺癌患者中，鳞癌的DNA—ICM检查敏感度（82．7％）高于腺癌的DNA—ICM检查敏感度（60．2％，P〈0．01）。结论DNA—ICM在肺癌诊断中有较大的应用价值，与LBC联合检查能提高肺癌的阳性检出率；BALF的DNA-ICM检查可推广应用于临床。Objective To explore the value of DNA-image cytometry （DNA-ICM） in diagnosis of lung cancer. Methods 532 cases of bronchoalveolar lavage fluid （BALF） and （or） bronchial brushing cytology （216 cases from lung cancer patients and 209 cases from benign lung disease patients） were detected by DNA-ICM and liquid-based cytology （ LBC ） , respectively. The sensitivity and specificity of the two methods were compared. Results The sensitivity and specificity of DNA-ICM were 69.2% and 100.0%, and which of LBC were 46.7% and 97.9%, respectively. The sensitivity of DNA-ICM was significantly higher than that of LBC method in the diagnosis of lung cancer （P〈0.05）. The sensitivity and specificity of DNA- ICM of BALF were 71.9% and 100.0%, while those of LBC were 48.2% and 98.5%. The sensitivity and specificity of DNA-ICM of bronchial brushing cytology were 62.8% and 100.0%, while those of LBC were 43.0% and 95.3%. The sensitivity of DNA-ICM of BALF and bronchial brushing cytology were higher than that of LBC method （P〈0.05）. There were 107 patients who underwent BALF and bronchial brushing cytology simultaneously, the sensitivity of DNA-ICM of BALF was higher than that of bronchial brushing cytology （P 〈 0.05 ）. Among different histologic types of the lung cancers, the sensitivity of squamous carcinoma was higher that of adenocarcinoma. Conclusions DNA-ICM has great application value in the diagnosis of lung cancer. DNA-ICM in combination with LBC can increase the detection rate of lung cancer. DNA-ICM of BALF is worthy of application in clinical practice.

关 键 词：肺肿瘤 诊断 DNA定量分析系统 液基细胞学 支气管肺泡灌洗液 纤维支气管镜刷片 

分 类 号：R734.2[医药卫生—肿瘤]