【摘要】 目的由于DNA-Index(DI)的定量细胞学诊断系统对于DI值在1～2.5增生细胞性状诊断的不足,探讨是否存在恶性变化倾向,并寻找能区分恶性变化的特征参数作为临床早期诊断的指标。方法肺癌组10名,10名肺结核患者为非癌组。取两组患者清晨自咳痰经液基薄层制片和Feulgen-Thinion染色,应用全自动细胞图像分析系统进行DNA定量分析。肺癌组每例在DI=1.0,1.5,2.0,2.5处各取10个细胞,非癌组每例在DI=1.0,1.5,2.0处各取10个细胞。对核面积(Area)、核半径变异(Var-radius)、形状(Sphericity)、核边界变化(Harmono3fft)、低密度染色质在核面积中所占百分比(Low-DNA-area)、中密度染色质在核面积中所占百分比(Med-DNA-area)和高密度染色质在核面积中所占百分比(Hi-DNA-area)等参数进行统计分析。结果在G0/G1期(DI=1.0),癌组与非癌组相比,各参数之间差异无显著性(P>0.05)。在S期(DI=1.5),Hi-DNA-area能显著区分肺癌组增生细胞的恶变(P<0.01)。Hi-DNA-area、Med-DNA-area和Harmono3fft 3个参数不仅能显著区分癌组高异倍体细胞(DI=2.5)(P<0.01),还能显著区分G2/M期癌组高度增生细胞(DI=2.0)的恶变(P<0.01)。Area和Low-DNA-area能识别痰中癌组高异倍体细胞(DI=2.5)的特征变化(P<0.01),而Var-radius和Sphericity不能识别痰中癌组高异倍体细胞(DI=2.5)的特征变化。结论依据Hi-DNA-area,Med-DNA-area和核边界变化(Harmono3fft)等参数,提高对DI在1～2.5之间增生细胞发生恶性变化的诊断。更多还原

【Abstract】 Objective Automated image cytometry could not accurately recognize malignant changes of plastic cells(DI=1-2.5) through DNA-Index(DI).The aim of the study was to determine the presence of malignant changes of these plastic cells(DI=1-2.5) in sputum specimens from patients with lung cancer and to find some nuclear features to recognize them.Methods Sputum cells from ten patients with lung cancer and ten tuberculous patients were used in the study.Automated image cytometry was performed on Feulgen-Thionin stained sputum of patients with lung cancer or with tuberculosis.In cancer group,ten cells were selected respectively in the range of DNA-Index(DI=1.0,1.5,2.0,2.5) for each patient.In non-cancer group,ten cells were selected respectively in the range of DNA-Index(DI=1.0,1.5,2.0) for each patient.The seven nuclear features were separately compared between the two groups.Results The seven nuclear features were not significant different between the lung cancer group and non-cancer group during G0/G1 phase(DI=1.0).In S phase(DI=1.5),the malignant proliferating cells in the cancer group could be distinguished by Hi-DNA-area(P<0.01).Hyperplastic cells(DI=2.0) in the cancer group and malignancy of hyperplastic cells(DI=2.0) in G2/M phase could be distinguished by the three parameters of Hi-DNA-area,Med-DNA-area,and Harmono3fft with P<0.01.Hyperplastic cells(DI=2.5) in sputum from the cancer group could be distinguished by Low-DNA-area,while the changes of nuclear features of hyperplastic cells(DI=2.5) from the cancer group could not be distinguished by var-radius and sphericity.Conclusion The diagnosis of malignancy of plastic cells(DI=1～2.5) could be improved based on parameters including Hi-DNA-area,Med-DNA-area,and Harmono3fft.更多还原