痰液细胞DNA含量分析对肺癌的诊断价值  

The diagnostic value of flow cytometric DNA analysis of sputum in lung cancer

作　　者：操乐杰[1] 翟志敏[2] 李俊[3] 徐美清[4] 夏淮玲[1] 徐晓玲[1] 马冬春[4] 梅晓冬[1] 崔皖芳[1] 

机构地区：[1]安徽省立医院呼吸科,合肥230001 [2]安徽省立医院中心实验室,合肥230001 [3]安徽医科大学附属第一医院细胞病理室 [4]安徽省立医院胸外科,合肥230001

出　　处：《中国肺癌杂志》2004年第3期202-205,共4页Chinese Journal of Lung Cancer

基　　金：安徽省科技厅重点科研基金 (0 1 0 2 30 2 4 )资助~~

摘　　要：目的　探讨痰液细胞DNA含量分析对肺癌的诊断价值。方法　用流式细胞仪对 44例患者 ( 2 9例肺癌、15例肺良性疾病患者 )痰液细胞DNA含量进行分析 ,并与痰细胞形态学检查结果作比较。对痰细胞学阴性而DNA含量分析阳性的对照患者组织切片行 p5 3、PCNA、Ki67免疫组化分析。 结果　以最后病理诊断为标准 ,肺癌患者异倍体检出的敏感性为 82 .8%,显著高于痰细胞学的敏感性 ( 2 7.6%) (P <0 .0 0 5 ) ;肺癌晚期异倍体阳性率高于早期肺癌 ( 87.5 %比 76.9%,P <0 .0 0 2 5 ) ,其中 1例肺癌患者提前临床 10月检出异倍体。部分炎性假瘤及结核球患者痰标本检出异倍体 ,其相应的组织切片PCNA、Ki67免疫组化染色亦阳性。结论　痰液细胞DNA含量分析是肺癌诊断有效的辅助方法 ,可能有利于肺癌的早期诊断。Objective To evaluate the diagnostic value of flow cytometric DNA analysis of sputum cells in lung cancer patients. Methods The DNA content of sputum cells was determined by flow cytometry in 44 patients (29 patients with lung cancer, and 15 patients with benign pulmonary disease). The results of DNA content of sputum cells were compared with those of cytologic morphology of sputum cells. Results The last pathologic diagnosis was used as a diagnostic criterion, the sensitivity of DNA heteroploidy analysis was 82.8% , which was significantly higher than that of sputum cytology (82.8% vs 27.6%, P <0.005); and the positive rate of heteroploidy in sputum samples in stage Ⅲ and Ⅳ disease was significantly higher than that in stage Ⅰ and Ⅱ disease (87.5% to 76.9%, P <0.002 5). In one case, the heteroploidy was found 10 months in advance of cytometry. In the control, heteroploidy was detected in 33.3% (2/6) patients with inflammatory pseudotumor and 50.0% (2/4) patients with tuberculous nodule, who were found with positive staining of Ki67 and PCNA. Conclusion Flow cytometry seems to be a valuable adjunctive method for the diagnosis of lung cancer, and probably for the early diagnosis.There are clonal changes in some inflammatory pseudotumor and tuberculous nodule.

关 键 词：肺肿瘤 流式细胞仪 DNA含量 痰细胞学 

分 类 号：R734.2[医药卫生—肿瘤] R342.3[医药卫生—临床医学]