【摘要】 目的 :探讨鼻咽细胞学检查结合DNA核型判断和细胞EB病毒检测在可疑鼻咽癌病人筛查中的作用。方法 :分别对 6 6例可疑鼻咽癌就诊病人作鼻咽刷片细胞学诊断和应用CAS2 0 0图像分析仪测定涂片细胞DNA含量 ,细胞学癌阳性病例同时作EB病毒编码RNA(EBERs)原位杂交。结果 :与组织学诊断相比 ,细胞学诊断和DNA非二倍体诊断癌的敏感性分别为6 6 %和 5 5 % ,两者结合判断不能提高敏感性 ,并且假阴性率高 ;细胞学癌阳性病例的癌细胞核EBERs阳性率 92 .1% ,其中 6例DNA二倍体核型病例均呈EBERs阳性 ,可诊断为鼻咽癌。结论 :鼻咽细胞学检查结合DNA核型判断不能提高可疑鼻咽癌病人的诊断率 ,不适用于鼻咽癌筛查。细胞涂片的EB病毒原位杂交方法 ,在鼻咽癌可疑病人的诊断和鉴别诊断上具有重大实用价值 ,在鼻咽癌筛查的作用有待进一步研究更多还原

【Abstract】 Purpose To analyze the suitability of the combined analysis of cytopathology and DNA cytometry and to detect the expression of Epstein Barr virus(EBV) encoded RNAs(EBERs) on nasopharyngeal brushes for diagnosis of nasopharyngeal carcinoma(NPC). Methods The cytological examination and the DNA ploidy analysis with a CAS 200 image analyzer were performed in 66 cases of suspicious NPC. The EBERs was detected on cancer positive smears by in situ hybridization in 38 out of 66 cases. Results Compared with the histologic diagnosis, the sensitivity of cytological diagnosis and ploidy analysis were 66% and 55% respectively in predicting the final diagnosis of malignancy. The sensitivity rate wasnt be improved by the combined analysis of cytopathology with DNA cytometry and the false negative diagnosis rate by the combined analysis was still high. EBERs was positive in 35 cases(92 1%) which may be diagnosed as NPC although 6 of 35 cases were DNA diploid. Conclusions The combined analysis of cytopathology with DNA cytometry is not suitable for screening NPC because it appears to be not sensitive for the detection of suspicious NPC. In situ hybridization for EBERs in cytological smears has a practical and important role in diagnosis and differentiation of suspicious NPC patients. Further study is needed to evaluate how to use EBERs as a screening tool for NPC.更多还原