【摘要】 目的 :探讨胸腹水脱落细胞的DNA含量对诊断良恶性胸腹水的应用价值。方法 :应用计算机图像分析仪 (ICM)测定 32例恶性胸腹水脱落细胞 (癌细胞、恶性间皮瘤细胞 )和 18例良性胸腹水脱落细胞 (正常和增生间皮细胞 )的DNA含量 ,以同一涂片内成熟淋巴细胞作对照进行DI测定、倍体分析、绘制DNA直方图 ,计算出其恶性细胞的检出率 ,并与常规脱落细胞学检查作比较。结果 :胸腹水中恶性肿瘤细胞 (癌细胞 ,恶性间皮瘤细胞 )的DNA含量明显增高 ,多为异倍体 (≥ 5C) ,DI值为 (3.85± 1.2 4 )。间皮细胞 (增生和正常间皮细胞 )的DNA含量多呈二倍体 ,DI值为 (1.35± 0 .2 3) ,二者差别有显著性 (P <0 .0 1)。恶性肿瘤细胞DNA分布直方图在 5C处形成主峰值 ,间皮细胞DNA分布直方图在 2C、3C处形成主蜂值。根据DNA测定结果 ,其恶性肿瘤细胞检出率为 87.5 % (2 8/ 32 ) ,常规脱落细胞学检出率为 71.9% (2 3/ 32 ) ,二者联合检查检出率为 90 .6 % (2 9/ 32 )。结论 :ICM具有经济、方便、准确等特点 ,应用其测定胸腹水脱落细胞学的DNA含量 ,并与常规脱落细胞学相结合 ,可提高恶性胸腹水的检出率 ,对诊断及鉴别诊断良恶性胸腹水具有重要临床意义。更多还原

【Abstract】 Objective: To explore the applying value of DNA content for the diagnosis of the exfoliat e d cell of benign and malignant hydrothorax and ascites with image cytometry(ICM) . Methods:The DNA content of 32 cas es of malignant exfoliative cell (the carcinoma cell and malignant mesothelioma cell) in hydrothorax and ascites, and that of 18 cases of benign exfoliati ve cell (the normal and prolifera tive cell) were examined with ICM . Compared with the mature lymphocytes in th e sa me smear, the DNA index (DI), DNA ploidy were examined, the bar graphs of DNA co ntent were drawn, and the positive examined rate of malignant cell which was com pared with the routine exfoliative cytology was worked out. Results:Most of DNA content of malignant exfoliative cell were heteroploid, DI was(3.85±1.24). Most of the DNA content of mesothelial cell we re diploid, DI was (1.35±0.23). There was significantly difference between the two kinds of cells (P< 0.01). In the DNA distribution bar graph s, the malignant cell reached pack at 5C, and the benign cell reached pack at 2C ,3C,respectively. According to the examined data, the positive examined rate of malignant cell was 87.5%(28/32). The positive examined rate of routine cytolo gy was 71.9%(23/32). Combined the two methods, the positive rate was 90.6%( 29/32). Conclusion:Examining the DNA content of the exfoliated cell of benign and malignant hydrothorax and ascites with ICM is economical, convenien t, a nd accurate. ICM, combined with routine cytology can rise the positive examined rate of malignant hydrothorax and ascites, has high diagnostic value for differe ntiation of the benign and malignant hydrothorax and ascites.更多还原