乳腺及甲状腺肿瘤液基联合ICM-DNA检测诊断价值探讨  

Application value on breast and thyroid tumors with ICM-DNA and liquid-based cytology

作　　者：任单阳 刘爱云[2] 贾兰 许艳梅[1] REN Dan yang;LIUAi-yun;JIA Lan;XU Yan-mei(Shanxian Central Hospital,Shanxian 274300,P.R.China)

机构地区：[1]单县中心医院病理科,山东单县274300 [2]单县中心医院检验科,山东单县274300

出　　处：《中华肿瘤防治杂志》2018年第17期1247-1250,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的细胞学检查是判断肿瘤良恶性的经济、方便检查方法,但是受取材、制片方式及诊断者主观性因素影响较大。本研究拟评价液基联合全自动DNA图像分析(DNA image cytometry,ICM-DNA)检测在乳腺及甲状腺肿瘤细胞学诊断中的应用价值。方法收集单县中心医院2012-01-01-2014-01-01行术中快速冷冻检查的乳腺肿块100例和甲状腺肿块158例,分别刮取新鲜肿瘤细胞行普通细胞涂片和液基配合ICM-DNA检测,以术后常规病理诊断结果为对照,比较2种细胞学检查方法的诊断符合率和阳性检出率,同时对细胞核DNA含量及倍体情况进行分析。结果在乳腺常见良恶性肿瘤中,液基配合ICM-DNA扫描定量分析方法诊断符合率为99.0%(99/100),阳性检出率为98.6%(73/74),明显高于普通细胞涂片的85.0%(85/100)和79.7%(59/74),χ~2值分别为13.315和10.562,均P<0.001。在乳腺浸润性导管癌病变中,分级越高,DNA含量越高,超二倍体细胞越多,F=11.26,P<0.05。甲状腺常见良恶性肿瘤中,液基配合ICM-DNA扫描定量分析法的诊断符合率为91.1%(144/158),阳性检出率为83.1%(69/83),明显高于普通细胞涂片的69.6%(110/158)和42.2%(35/83),χ~2值分别为21.066和11.042,均P<0.001。甲状腺恶性肿瘤间DNA含量差异无统计学意义,P>0.05。结论液基配合ICM-DNA检测方法能显著提高乳腺及甲状腺肿瘤的诊断符合率和阳性检出率,有助于良恶性肿瘤的鉴别,为临床诊断提供有价值的参考指标。DNA含量和DNA倍体特征与乳腺癌的分化程度有关。OBJECTIVE To evaluate the usage of ICM-DNA with liquid-based cytology（LBC） in diagnosis of breast tumor and thyroid tumor. METHODS Total 100 cases of breast neoplasm patients and 158 cases of thyroid tumor patients who underwent frozen section diagnosis in surgery from Jan 1,2012 to Jan 1,2014 were involved in this study. Traditional diagnosis method and ICM-DNA with LBC were applied in parallel, and the results were compared to postoperative patho- logical diagnosis outcome. The accordance rate and positive rate of the two methods were compared,meanwhile DNA con- tent and the ratio of hyperdiploid were also analyzed. RESULTS In breast tumor,ICM DNA with LBC appears higher ac- cordance rate （99.0 %, ;χ2 = 13.315, P〈0.001 ） and positive rate （98.6 %, ;χ2 = 10.562, P〈0.001 ）. DNA contents and the ratio of hyperdiploid shows higher in invasive breast ductal carcinoma,the lower differentiation,the higher DNA contents and the ratio of hyperdiploid were present （F= 11.26 P〈0.05）. In thyroid tumor,it was also found that ICM-DNA with liquid-based cytology method significantly increased accordance rate （91. 1%, χ2 = 21. 066, P〈0. 001 ） and positive rate （83.1 %,χ2 = 11. 042 9, P〈0. 001）, compared to the other. In addition, no significant difference were found between dif- ferent types of thyroid carcinoma （P〈0.05）. CONCLUSIONS ICM-DNA with LBC significantly increases accordance rate and positive rate in diagnosis of breast tumor and thyroid tumor,which is obviously helpful in differentiating malig- nancy and benignity. DNA contents and the characteristics of DNA ploidy are correlated with the degree of differentiation in some malignant neoplasms.

关 键 词：肿瘤细胞学 细胞涂片 液基细胞制片 全自动DNA图像分析 

分 类 号：R737.9[医药卫生—肿瘤] R736.1[医药卫生—临床医学]