角结膜缘上皮性肿瘤DNA含量测定对于病理诊断的意义

The effects of DNA ploidy measurement on pathologic diagnosis of limbus epithelial neoplasms

应用真彩色图象分析法,采用定量病理技术,测定了51例角结膜缘上皮性新生物(上皮良性增生、上皮非典型性增生、原位癌和鳞状细胞癌)细胞核内的DNA含量。发现,上皮良性增生病变中,二倍体～四倍体(2C-4C)细胞占88.59%,≥五倍体(≥5C)细胞仅占11.41%;上皮非典型性增生中,2C-4C细胞占58.62%,≥5C细胞占41.38;原位癌、鳞状细胞癌中,2C-4C细胞分别为21.11%和21.69%,而≥5C细胞则分别占78.89%和78.31%。经统计学分析,发现有非常显著性差异(P<0.01)。认为,应用此技术可作为辅助临床病理诊断的有效手段,并可从肿瘤的细胞生物学行为来评估患者的临床预后。

An apparatus of true color medical photometric analysis, a quantitative pathologic technique, was adopted to measure DNA ploidy content in 51 cases with limbus epithelial neoplasm. According to the DNA pattern, the cells in the neoplasm were divided into 4 types: diploid (2C), tri-to tetraploid (3-4C), pentaploid (5C) and≥5C. In the lesion of epithelial hyperplasia, 2C-4C ceils accounted for 88.59%, and≥5C cells, 11.41%. In atypical hyperplasia, 2C-4C cells accounted for 58.62% and ≥5C cells, 41.38%. In the cases of carcinoma in situ and squamous cell carcinoma, 2C-4C cells accounted for 21.11% and 21.69%, and ≥5C cells, 78.89% and 78.31% respectively. These data were analyzed between each two groups by x^2 test (P<0.01). Our study shows that when a limbus lesion develops from bening hyperplasia via atypical hyperplasia to carcinoma, the proportion of 2C-2C cells in the DNA ploidy content decreases gradually or remarkably, and that of≥5C cells increases obviously. The quantitative measurement of DNA content is a useful assisting method to enhance the level of ocular pathologic diagnosis and to evaluate the patient's prognosis correctly.