【作者】 陶伟；

【导师】 李俊；

【作者基本信息】 安徽医科大学 ， 肿瘤学， 2016， 硕士

【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(P<0.01)。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(P<0.05)。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(P<0.01)。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。更多还原

【Abstract】 Objective: To investigate the value of DNA image cytometry in the diagnose of lung cancer by comparing with the Liquid-based cytology results, looking for reliable method in early diagnosis of lung cancer.Materials and Methods: Using DNA image cytometry and Liquid-based cytology of 570 lung cancer group specimens(including 246 sputum specimens, 226 bronchoalveolar lavage fluid specimens, 98 bronchial brushing specimens),and 465 lung cancer group specimens(including 213 sputum specimens, 205 bronchoalveolar lavage fluid specimens, 47 bronchial brushing specimens).Results: The sensitivity of DNA-ICM of BALF and sputum cytology were 71.2% and 41.9%, while LBC were 49.1% and 22.4%. The sensitivity of DNA-ICM of BALF and sputum cytology were higher than that of method of LBC(P<0.01). There were 117 patients who underwent BALF and bronchial brushing cytology, The sensitivity and specificity of DNA-ICM of BALF were 77.5% and 100%, The sensitivity and specificity of LBC of bronchial brushing were 58.8% and 100%. The sensitivity of DNA-ICM of BALF was higher than that of bronchial brushing cytology(P<0.05). Of the 246 cases which had histopathological results, the sensitivity of adenocarcinoma was 59.8%, the sensitivity of squamous carcinoma was 77.4%, the sensitivity of squamous carcinoma was higher that of adenocarcinoma(P<0.01).Conclusions: DNA-ICM has great application value in the diagnose of lung cancer, both in the sputum and bronchoalveolar lavage fluid specimens, the sensitivity of DNA-ICM of BALF and sputum cytology were higher than that of method of LBC, in a certain extent, can reduce the missed diagnosis; and can increase the positive rate with Liquid-based cytology; BALF is more preponderant than bronchial brushing cytology by DNA-ICM in the diagnose of lung cancer which can be applied in clinical.更多还原