利用图象分析诊断胃良、恶性病变的可行性研究

Clinical observation and research of using measurement parameter diagnosing stomach benign and malignant pathological change

目的：探讨胃的慢性炎症、肠上皮化生、异型增生、癌与ＤＮＡ指数（ＤＩ）及倍体分布的关系。方法：慢性胃炎３２例、肠上皮化生３１例、异型增生３４例、癌７３例，用多媒体彩色病理图文分析系统（ＭＰＩＡＳ－５００）测量各组病变细胞核ＤＩ值及倍体分布情况。结果：ＤＮＡ含量在各组病变胃粘膜中有显著差异（Ｐ＜０．００１）；倍体构成在慢性炎症、肠上皮化生、异型增生之间无显著差异（Ｐ＞０．０５），慢性炎症、肠上皮化生、异型增生与癌之间差异均有显著性（Ｐ＜０．０５）。结论：胃良、恶性病变细胞核ＤＮＡ含量及非整倍体细胞所占百分比不同。形态定量分析检测细胞核ＤＩ值及ＤＮＡ倍体分布，可作为胃良、恶性病变诊断和分类的辅助诊断，并有助于指导临床治疗和估计肿瘤的恶性潜能。

Purpose To study the correlation between gastritis, intestinal metaplasia, dysplasia, carcinoma and DNA index ( DI ), ploidy classes. Methods The distributions of ploidy and content of DNA were measure using MPIAS 500 in 32 cases of gastritis, 31 cases of intestinal metaplasia, 34 cases of dysplasia, 73 cases of carcinoma. Results Gastritis DI =1 049, intestinal metaplasia DI =1 263, dysplasia DI =1 38, carcinoma DI =1 56. Gastritis and intestinal metaplasia were evidently different from dysplasia and remarkably different from carcinoma. The difference also existed between dysplasia and carcinoma. Conclusion The DNA content and nondiploid cell take up different percentage in the stomach benign and malignant nucleus. Quantitating analysis and survey of nucleus DNA index and ploidy classes can be used as one of the comprehensive indexes to diagnose and classify stomach benign and malignant pathological change, which is helpful to conduct clinical treatment and estimate the malignant potential of tumor.