细胞图像DNA倍体分析在恶性胸腔积液病理诊断中的应用  

Application of DNA image cytometry ploidy analysis in pathological diagnosis of malignant pleural effusion

作　　者：刘玲玲 李丽 吴翠玲 侯丽娟 郑文亮 Liu Lingling;Li Li;Wu Cuiling;Hou Lijuan;Zheng Wenliang(Department of Pathology,the Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030032,China;Department of Pathology,Shaanxi Provincial Cancer Hospital,Xi'an Jiaotong University School of Medicine,Shaanxi Third People's Hospital,Xi'an 710065,China)

机构地区：[1]山西白求恩医院(山西医学科学院、同济山西医院)、山西医科大学第三医院病理科,太原030032 [2]西安交通大学医学院附属陕西省肿瘤医院、陕西省第三人民医院病理科,西安710065

出　　处：《肿瘤研究与临床》2024年第2期128-131,共4页Cancer Research and Clinic

摘　　要：目的探讨细胞图像DNA倍体分析(DNA-ICM)在恶性胸腔积液病理诊断中的应用价值。方法回顾性病例系列研究。回顾性分析山西白求恩医院2021年10月至12月101例胸腔积液患者的临床资料,对胸腔积液标本进行液基细胞学检查(LBC)和DNA-ICM,结合患者的临床诊断、影像学检查、活组织检查和随访结果,比较两种方法的灵敏性和特异性。结果101例患者的胸腔积液中,恶性胸腔积液39例,良性胸腔积液62例。LBC和DNA-ICM诊断胸腔积液中恶性肿瘤细胞的灵敏度分别为74.7%和94.9%,特异度分别为98.4%和83.9%;二者联合比单独LBC诊断阳性率提高[36.6%(37/101)比28.7%(29/101)]。对7例DNA-ICM阳性但LBC结果为阴性病例进行随访,其中1例诊断为小细胞肺癌。结论DNA-ICM可有效提高胸腔积液细胞学阳性检出率,DNA-ICM和LBC联合检测可降低细胞学漏诊率,对恶性胸腔积液病理诊断具有重要的临床价值。Objective To explore the clinical application value of DNA image cytometry ploidy analysis(DNA-ICM)in the pathological diagnosis of malignant pleural effusion.Methods A retrospective case series study was conducted.The clinical data of 101 patients with pleural effusion from October to December 2021 in Shanxi Bethune Hospital were retrospectively analyzed.Liquid-based cytology(LBC)and DNA-ICM were performed on pleural effusion specimens.The sensitivity and specificity of the two methods were compared with the clinical diagnosis,imaging,biopsy,and follow-up results of the patients.Results Among the pleural effusions of 101 patients,39 were malignant pleural effusions and 62 were benign pleural effusions.The sensitivity of LBC and DNA-ICM in diagnosing malignant tumor cells in pleural effusions was 74.7%and 94.9%,respectively,and the specificity was 98.4%and 83.9%,respectively;the combination of the two had an increased diagnostic positivity rate compared with that of LBC alone[36.6%(37/101)vs.28.7%(29/101)].Seven cases with positive DNA-ICM but negative LBC result were followed up,and 1 case was diagnosed as small cell lung cancer.Conclusions DNA-ICM can effectively improve the positive cytology detection rate of pleural effusion,and the combined detection of DNA-ICM and LBC can reduce the underdiagnosis rate of cytology,which is of great clinical value in the pathological diagnosis of malignant pleural effusion.

关 键 词：胸腔积液 恶性 细胞图像DNA倍体分析 液基细胞学 诊断 

分 类 号：R730.43[医药卫生—肿瘤]