FISH与痰脱落细胞学在肺癌检测中的对比研究

Comparison between FISH and cytology of sputum samples in detection of lung cancer

目的探讨荧光原位杂交技术(fluorescence in situ hybridization,FISH)检测痰液中脱落细胞进行肺癌诊断的可行性,并与痰脱落细胞学比较。方法选用3、7、17号染色体着丝粒探针,p16、p53探针和痰脱落细胞学技术,分别检测40例疑似肺癌患者的痰液,同期行痰脱落细胞学检查。20例健康人痰液标本,用于建立FISH阈值,作为阳性判断标准。结果 FISH和细胞学检查的敏感度分别为80.6%和22.6%,特异性分别为77.8%和100.0%,诊断符合率为80.0%和40.0%。两种方法在敏感度和诊断符合率上差异具有统计学意义(P<0.05),而特异性差异无统计学意义(P>0.05)。结论在肺癌诊断中FISH较常规细胞学具有更高的敏感度和诊断符合率,FISH技术能明显改进肺癌的诊断,可以作为肺癌诊断方法的补充。

Objective To evaluate the application of fluorescence in situ hybridization （FISH） assay in sputum for detection of lung cancer and to compare the results with sputum cytology test. Methods Sputum samples from 40 patients with suspected lung cancer were collected for cytology and FISH analysis. FISH was petformed using 3,7,17 and p16, p53 of chromosome-specific probes to examine chromosome aberration of exfoliated cells. FISH abnormality threshold was determined by evaluating the sputum specimen from 20 normal subjects. Results The sensitivity for lung cancer of FISH and cytology in sputum was 80.6% and 22.6%, respectively; specificity was 77.8% and 100.0% ; diagnostic concordance rate was 80.0% and 40.0%, respectively. Significant difference was found in specificity and diagnostic concordance rate between two methods （ P 〈 0.05 ）. Conclusion The sensitivity and efficiency of FISH in detection of lung cancer are superior to those of cytology, and FISH in sputum samples can be a supplementary method for diagnosis of lung cancer.