细胞DNA倍体分析和EBERs原位检测在鼻咽癌早期诊断中的应用

APPLICATION OF DNA PLOIDY ANALYSIS AND EBERs DETECTION TO EARLY DIAGNOSIS OF NASOPHARYNGEAL CARCINOMA

目的 探讨鼻咽脱落细胞进行DNA倍体和EB病毒编码RNA (EBERs)检测在鼻咽癌诊断中的应用。方法 对 38例经细胞学诊断为鼻咽癌和 8例为正常的鼻咽细胞涂片分别进行图像分析测定细胞DNA含量和EB病毒EBERs原位杂交检测。结果 与病理细胞学诊断相比 ,DNA异倍体分析和EBERs检测诊断癌的敏感性分别为 5 0 %和 92 %,其特异性均为 10 0 %;其阴性预测值分别为 30 %和 72 %。结论 与EBERs检测相比 ,DNA异倍体分析的诊断敏感性和阴性预测值较低 ,差异具有显著性 (分别为P <0 0 0 1和P <0 0 5 )。证明在鼻咽细胞学涂片应用EB病毒原位杂交检测诊断鼻咽癌优于应用DNA异倍体分析诊断。与细胞DNA图像分析相比 ,EB病毒原位杂交检测具有客观、实验条件简单等优点 ,在鼻咽癌可疑病人的早期诊断和鉴别诊断上具有重要的实用价值。

Objective To evaluate the application of the DNA ploidy analysis and the detection of Epstein-Barr virus (EBV) encoded RNAs (EBERs) to the early diagnosis of nasopharyngeal carcinoma (NPC) .Method Based on cytological examination, 38 NPC cytological smears and 8 normal nasopharyngeal smears were analyzed in DNA ploidy with an image analyzer and in EBERs by in situ hybridization. Result Compared with the cytological diagnosis, DNA aneuploidy analysis and EBERs detection demonstrated a sensitivity of 50% and 92%, respectively, with the same specificity of 100% for predicting a diagnosis of cancer. Their negative predictive values were 30% and 72% respectively. Conclusion There was a significant difference between DNA aneuploidy analysis and EBERs analysis in sensitivity (P<0.001) and in negative predictive value (P<0.05). EBERs analysis in cytological smears showed a role superior to that of DNA aneuploidy analysis in the diagnosis of NPC. Considering its advantages of simple experimental conditions, EBERs detection can play a practical and important diagnostic role in patients suspected of having primary NPC.;