痰液细胞DNA倍体定量分析技术在肺癌早期无创筛查中的应用  

Application of sputum cell DNA ploidy quantitative analysis technique in early non-invasive screening of lung cancer

作　　者：韩卫 张晓彤 Han Wei;Zhang Xiaotong(Department of Laboratory, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou Mining Group General Hospital, Xuzhou 221006, China)

机构地区：[1]徐州医科大学第二附属医院徐州矿务集团总医院检验科,221006

出　　处：《肿瘤研究与临床》2019年第9期618-621,共4页Cancer Research and Clinic

摘　　要：目的探讨痰液细胞DNA倍体定量分析技术在肺癌早期无创筛查中的应用价值。方法回顾性分析徐州医科大学第二附属医院2016年4月至2017年5月收治的84例肺癌患者(肺癌组)及84例肺良性疾病患者(肺良性疾病组)的临床资料,以80名健康体检者作为对照组。收集所有受试者痰液标本,同时收集55例肺癌组患者相应灌洗液标本。所有标本均使用全自动细胞肿瘤筛查分析系统进行DNA倍体定量分析检测,并将检测结果与痰液涂片和液基薄层细胞学结果进行对比分析。结果肺癌组常规涂片、液基薄层细胞学和DNA倍体定量分析的阳性检出率分别为4.76%(4/84)、29.76%(25/84)和45.24%(38/84),液基薄层细胞学和DNA倍体定量分析的阳性检出率均高于常规涂片,差异均有统计学意义(χ2=18.38,P<0.01;χ2=36.70,P<0.01);DNA倍体定量分析的阳性检出率高于液基薄层细胞学,差异有统计学意义(χ2=4.29,P=0.038)。灌洗液标本的DNA倍体定量分析阳性检出率为65.45%(36/55),高于痰液标本的50.91%(28/55),但两者差异无统计学意义(χ2=2.39,P=0.122)。周围型肺癌患者的DNA倍体定量分析阳性检出率高于液基薄层细胞学(χ2=4.55,P=0.033)。痰液标本的DNA倍体定量分析对鳞状细胞癌的阳性检出率为52.17%(24/46),高于腺癌[36.36%(8/22)]、小细胞癌[26.36%(4/11)]和腺鳞癌[40.00%(2/5)],但差异均无统计学意义(均P>0.05)。结论痰液细胞DNA倍体定量分析技术较传统涂片法及液基薄层制片技术能更直观地反映肺癌早期患者恶性变,其阳性检出率较常规检测方法更高,是临床早期筛查肺癌有价值的参考指标。Objective To investigate the application value of sputum cell DNA ploidy quantitative analysis technique in early non-invasive screening of lung cancer. Methods The clinical data of 84 patients with lung cancer (lung cancer group) and 84 patients with benign lung disease (lung benign disease group) who were admitted to the Second Affiliated Hospital of Xuzhou Medical University from April 2016 to May 2017 were retrospectively analyzed, and 80 healthy subjects were selected as the control group. The sputum samples of all subjects were collected, and 55 corresponding lavage fluid samples in the lung cancer group were also collected. A fully automated cell tumor screening analysis system was used to make DNA ploidy quantitative analysis in all specimens, and the results were compared with sputum smear and liquid-based thin-layer cytology results. Results The positive detection rates of routine smear, liquid-based thin-layer cytology and DNA ploidy quantitative analysis in lung cancer group were 4.76%(4/84), 29.76%(25/84) and 45.24%(38/84). The positive detection rate of liquid-based thin-layer cytology and DNA ploidy quantitative analysis was higher than that of routine smear, and the differences were statistically significant (χ 2 = 18.38, P < 0.01;χ2 = 36.70, P < 0.01);the positive detection rate of DNA ploidy quantitative analysis was higher than that of liquid-based thin-layer cytology, and the difference was statistically significant (χ 2 = 4.29, P = 0.038). The positive detection rate of DNA ploidy quantitative analysis in lavage fluid samples was higher than that in sputum samples [65.45%(36/55) vs. 50.91%(28/55)], but the difference was not statistically significant (χ 2 = 2.39, P = 0.122). For peripheral lung cancer patients, the positive detection rate of DNA ploidy quantitative analysis was higher than that of liquid-based thin-layer cytology (χ 2 = 4.55, P = 0.033). The positive detection rate of squamous cell carcinoma [52.17%(24/46)] by using DNA ploidy quantitative analysis was higher than that o

关 键 词：肺肿瘤 痰液 DNA倍体 诊断 

分 类 号：R734.2[医药卫生—肿瘤]