细胞DNA定量分析在肺癌诊断中的应用价值

发布时间：2019-01-02 12:14

【摘要】：目的:通过与液基薄层细胞学技术(liquid-based cytology,LBC)相比较,探讨细胞DNA定量分析技术(DNA image cytometry,DNA-ICM)在肺癌诊断中的应用价值,寻找肺癌早期诊断的有效方法。方法:采用DNA定量分析技术和液基薄层细胞学技术对肺癌组570个标本(其中痰液标本246个,BALF标本226个,纤维支气管镜刷片标本98个)和非肺癌组465个标本(其中痰液标本213个,BALF标本205个,纤维支气管镜刷片47个)进行比较分析。结果:DNA-ICM在BALF中检查的敏感度为71.2%,特异度为100%;LBC在BALF中检查的敏感度为49.1%,特异度为97.6%。DNA-ICM在痰液中检查的敏感度为41.9%,特异度为100%;LBC在痰液中检查的敏感度为22.4%,特异度为98.1%。与LBC相比较,两种标本DNA-ICM的敏感度均较高(P0.01)。117例同时采集BALF和纤维支气管镜刷片的患者中,DNA-ICM在BALF中的敏感度为77.5%,特异度为100%。DNA-ICM在纤维支气管镜刷片中的敏感度为58.8%,特异度为100%。DNA-ICM在BALF中的敏感度高于纤维支气管镜刷片中的敏感度(P0.05)。在病理组织分型不同的肺癌患者中,DNA-ICM在腺癌中的敏感度为59.8%,DNA-ICM在鳞癌中的敏感度为77.4%。DNA-ICM在鳞癌的敏感度高于腺癌(P0.01)。结论:细胞DNA定量分析技术在肺癌诊断中有较大的应用价值,无论是在痰液还是支气管肺泡灌洗液以及纤维支气管镜刷片标本中,细胞DNA定量分析技术的敏感度均较液基细胞学诊断技术高,在一定程度上能够减少漏诊率;与LBC联合检查能提高肺癌的阳性诊断率,可作为肺癌早期诊断的新手段,值得推广应用于临床。
[Abstract]:Objective: to explore the value of cell DNA quantitative analysis (DNA image cytometry,DNA-ICM) in the diagnosis of lung cancer by comparing with liquid based thin layer cytology (liquid-based cytology,LBC), and to find an effective method for early diagnosis of lung cancer. Methods: a total of 570 lung cancer specimens (including 246 sputum specimens and 226 BALF specimens) were examined by DNA quantitative analysis and liquid-based thin layer cytology. A comparative analysis was made between the fiberoptic bronchoscopic brushes (98 specimens) and non-lung cancer group (sputum (213 specimens), BALF specimens (205 specimens) and fiberoptic bronchoscopy brushes (47 specimens). Results: the sensitivity of DNA-ICM in BALF was 71.2 and the specificity was 100. The sensitivity of LBC in BALF was 49.1, the specificity of 97.6%.DNA-ICM in sputum was 41.9, the specificity of 97.6%.DNA-ICM in sputum was 22.4and the specificity was 98.1. The sensitivity of DNA-ICM in both specimens was higher than that of LBC (P0.01). The sensitivity of DNA-ICM in BALF was 77.5% in 117 patients who collected both BALF and fiberoptic bronchoscopic brushes. The sensitivity of 100%.DNA-ICM in fiberoptic bronchoscopic brushes was 58.8, and the specificity of 100%.DNA-ICM in BALF was higher than that in fiberoptic bronchoscopic brushes (P0.05). In lung cancer patients with different histological types, the sensitivity of DNA-ICM in adenocarcinoma was 59.8%. The sensitivity of 77.4%.DNA-ICM in squamous cell carcinoma was higher than that in adenocarcinoma (P0.01). Conclusion: quantitative analysis of cell DNA is of great value in the diagnosis of lung cancer, both in sputum, bronchoalveolar lavage fluid and bronchofiberscope brush specimen. The sensitivity of quantitative analysis of cell DNA was higher than that of liquid-based cytology, and the rate of missed diagnosis could be reduced to some extent. Combined with LBC can improve the positive diagnosis rate of lung cancer and can be used as a new method for early diagnosis of lung cancer.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R734.2

【参考文献】