【摘要】 目的 :探讨无创的脱落细胞形态学检查及微核计数的临床意义 ,评价脱落细胞学在追踪观察白斑及其在癌变早期诊断上的实用价值。方法 :对 2 6例白斑和 18例鳞癌患者的口腔粘膜脱落细胞涂片 :①进行巴氏染色 ,分析细胞学角化分型、细胞学巴氏分级与病变性质的关系 ;②计数微核细胞率 ,分析细胞学巴氏分级与微核计数的联系。结果 :上皮单纯增生的白斑均为混合角化 ,鳞癌多为不全角化。白斑和鳞癌 ,上皮单纯增生的白斑和鳞癌之间细胞学角化分型有显著性差异 (P <0 .0 0 1)。上皮异常增生的白斑中 ,6 3.6 4%为巴氏Ⅱ级 ,而上皮单纯增生的白斑中 ,6 .6 7%为巴氏Ⅱ级。白斑和鳞癌的细胞学诊断有显著性差异 (P <0 .0 0 1)。不同巴氏分级的患者 ,病损处微核细胞率无显著性差异。结论 :脱落细胞涂片出现不全角化的病例发生癌变或癌前病变的可能性较大。白斑患者脱落细胞涂片中一旦发现细胞学上异形的细胞 ,就要考虑其组f学上异常增生的可能。微核计数变化的出现早于细胞形态学变化。更多还原

【Abstract】 砄bjective: To evaluate the diagnostic significance of exfoliative cytological examination and micronucleus assay. Methods: 26 cases of leukoplasia (LK) and 18 cases of oral squamous cell carcinoma (SCC) were examined. Cells were scrapped from the lesions, stained with Papaniceolaou. The keratinization types and the configuration of the cells were studied. Smears were also stained using the Feulgen plus fast green method. The frequency of micronucleated cells was counted. Results: Mixed keratinization was observed in all 15 cases of LK without dysplasia and in 7 out of 11 cases of LK with dysplasia. Parakeratosis was found in 17 out of 18 cases of SCC. There was a significant difference of cell keratinization types and cytologic diagnosis between the cases of LK and SCC( P <0.001). Papaniceolaou type Ⅰ,Ⅱ and Ⅲ cell (%) in LK without dysplasia were 93.33, 6.67 and 0, in LK with dysplasia 27.27,63.64, and 9.09, in SCC 0, 16.67 and 83.33, respectively( P <0.01, LK VS SCC). Micronuclei in cytopatholgic classification of Papaniceolaou type Ⅰ,Ⅱ and Ⅲ cells (%) were 0.99±0.06, 0.98±0.06 and 1.05±0.10 respectively( P >0.05).Conclusion: Parakeratosis in oral exfoliative cells may indicate a high risk of malignance.更多还原