ICM-DNA定量检测在鉴别良恶性肿瘤诊断中应用

Application of Image Cytometry (ICM) quantitative in differential diagnosis of benign or malignant tumors

目的 探索ICM -DNA定量检测在鉴别良恶性肿瘤诊断中的应用。方法 对 12 1例原先不提供临床病史和病理检查结果的组织切片作改良的DNA染色和ICM -DNA定量检测。结果 (1) 36例无ICM -DNA定量恶性指数的病例中 ,与原先临床及病理结果有 34例相吻合 ,其DNA指数 (DI) 0 .72 - 1.10 ,中位数DI 1.0 ,2倍体 (C)、3- 4C和≥ 5C细胞所占中位数百分比分别为 71.33%、2 6 .2 1%和 0 .98%。 (2 ) 85例有恶性指数与原先临床及病理结果完全一致 ,其DI自 1.2 - 2 .72 ,中位数DI 1.33,2C、3- 4C和 5C细胞所占的中位数百分比分别为 2 9.4 1%、6 2 .6 2 %和4 .76 %。 (3) 85例恶性组的DNA直方图表型为 :近二倍体肿瘤占 14.12 % (12 /85) ,近四倍体肿瘤占 2 .35% (2 /85) ,多倍体肿瘤占 5.88% (5/85)和非整倍体肿瘤 77.6 5% (6 6 /85)。近二倍体肿瘤多为黏膜相关淋巴瘤、高分化癌和低度恶性软组织肉瘤。结论 ICM -DNA定量分析中DI值、倍体分布、异倍体的比例和DNA直方图表型不仅是判别良恶性肿瘤的重要依据 ,而且正确运用内参和外参照校正ICM检测基准 ,合理的定标更是ICM -DNA定量鉴别良恶性肿瘤的关键。

Objective Exploring Image cytometry (ICM) quantitative of nuclear DNA was used as an aid in differential diagnosis of the tumors, which were hard to decide exactly whether its were benign or malignant in routine pathologic diagnosis. Methods Paraffin section of 121 cases of various tumors without clinical history and original pathologic diagnosis was stained with DNA staining, and compared the results with the original pathologic diagnosis. Results (1)34/36 cases of benign tumors detected by ICM-DNA as compared with the benign tumors originally diagnosed, it's DNA index (DI) were 0.72～1.10, the median of DI 1.0, the median of 2C, 3～4C,>5C in the histogram were 71.3%, 26.2% and 0.98% respectively; (2)85 cases of malignant tumors detected by ICM-DNA, DI was 1.2～2.72, the median of DI 1.33, the median of the tumor cells in 2C, 3～4C, >5C were 29.4%, 62.6% and 4.8% respectively; (3)85 cases of malignant tumors detected by ICM-DNA, it's near-diploid was 14.41% (12/85), near-tetraploid was 2.4% (2/85), multiploid was 5.9% (5/85), and aneuploid was 7.7% (66/85). Most of the diploid tumors were mucous-membrane related lymphomas, highly differentiated carcinomas or low malignant soft tissue sarcomas. Conclusion The measurement of tumor DNA content, DNA index, and histogram of ploidy distribution of tumor cells by ICM-DNA is likely to become a reliable adjudge to the clinical and pathological assessment of cancer. But the reliability and stability of the ICM, and the internal control and tumor cells selected to measure are very important.