全自动细胞图像分析系统在炎性和癌性腹水鉴别诊断中的作用  

Differential Diagnosis of Benign and Mal ignant Peritoneal Effusions by Automatic Imaging Cytometer

作　　者：刘树刚 孙小蓉[2] 沈佳 李桂榕 张敏 李噁珩 晏想成 

机构地区：[1]武汉钢铁集团第二医院肿瘤科,武汉430080 [2]武汉兰丁肿瘤早期诊断检测中心 [3]武汉市七医院传染科,武汉430071

出　　处：《华中科技大学学报（医学版）》2003年第6期654-656,659,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家科委九五攻关基金资助项目 (No 96 90 1 0 7 0 3 )

摘　　要：目的　应用全自动细胞图像分析系统 (automaticimagingcytometer ,AICM )鉴别炎性和癌性腹水。方法 63例腹水标本 ,经离心涂片 ,每例制成 4张薄层细胞片。 2张细胞片做巴氏染色 ,用于常规细胞学检查。另 2张经Feulgen Thionin染色 ,用AICM进行细胞核DNA定量测定检查。每例标本受检细胞总数不少于 40 0 0个。结果　 63例腹水标本经临床或病理诊断证实 ,2 6例为炎性腹水 ,3 7例为癌性腹水。常规细胞学方法对炎性腹水和癌性腹水的的诊断阳性率分别为 88%、 84% ,AICM的诊断阳性率分别为 10 0 %、 92 %。癌性腹水的检测中 ,AICM可检出数量不等的DI >2 5细胞 ,而炎性腹水不能检出该类细胞。在癌性腹水标本中 ,异倍体细胞与细胞总数的百分比 (恶性间皮瘤 3 4% ,转移性癌 9 7% )明显高于炎性腹水标本 (<0 6% ) ,而炎性细胞与受检细胞总数的百分比 (恶性间皮瘤 5 8% ,转移性癌 4 8% )远低于炎性腹水 (46 8% )和结核性腹水 (8 8% )。结论　AICM用于炎性和癌性腹水的鉴别诊断较常规细胞学方法更客观。Objective To differentially diagnose benign and malignant peritoneal effusions by using automatic imaging cytometer (AICM). Methods In 63 samples of peritoneal effusion, cells of periton eal effusion were spun on 4 slides by a cytospin in each sample. Two slides were stained by Papanicolaou method for cytology analysis, and other 2 slides were s tained with Feulgen method for detection of DNA content of a minimum of 4000 nuc lei by AICM. Results Clinically or pathologically, of 63 samples of peritone al effusion, 26 were classified as benign and other 37 as malignant. Cytological investigation showed 88 % sensitivity for benign and 86 % sensitivity for malig nant effusions, while DNA imaging analysis revealed 100 % sensitivity for benign and 92 % sensitivity for malignant effusions respectively. In the samples of ma lignant effusions, different quantity of DI>2 5 cells could be detectable by AI CM, but in the samples of benign effusions, no DI>2 5 cells were detectable. Pe rcentages of leukocytes in acute inflammatory (46 8 %) and tuberculous (8 8 %) effusions were significantly higher than malignant peritoneal effusions (malign ant mesothelioma-5 8 %; metastatic neoplasia 4 8 %). Compared to benign perit oneal effusions (less than 0 6 %), percentage of aneuploid population in malign ant peritoneal effusions was significantly increased (malignant mesothelioma-3 4 %; metastatic neuplasma-9 7 %). Conclusion ACAM can be used to differentially diagnose benign a nd malignant peritoneal effusion more objective and sensitive than routine cytol ogical methods.

关 键 词：全自动细胞图像分析系统 癌性腹水 鉴别诊断 炎性腹水 

分 类 号：R442.5[医药卫生—诊断学]