细胞DNA定量分析技术在乳腺导管非典型增生与癌变鉴别中的诊断价值

Differential Diagnosis of Breast Ductal Atypical Hyperplasia Versus Cancer by Cellular DNA Quantitative Cytology

【目的】探讨细胞DNA定量分析技术在乳腺导管非典型增生与癌变鉴别中的诊断价值。【方法】收集正常乳腺组织30例（Ⅰ组），乳腺导管轻中度不典型增生22例（Ⅱ组）、重度不典型增生30例（Ⅲ组）及浸润性导管癌42例（Ⅳ组），采用常规制片脱蜡酶消法制片，经Feulgen染色后应用全自动细胞DNA定量分析仪对切片作图像分析，其指标包括：细胞相对DNA 含量（DI值）、S期细胞比率（SPF）、正常G0／G1细胞DNA 含量的半数（1C），二倍体细胞（2C 细胞）等。【结果】从Ⅰ～Ⅳ组，DI及SPF逐渐增高（ P ＜0．05），且组间比较有统计学差异（ P ＜0．05）；从Ⅰ～Ⅳ组，含有2C细胞的比例逐渐降低，而含有3C、4C、5C细胞的比例逐渐增高（ P ＜0．05），Ⅰ组、Ⅱ组及Ⅲ组不含有异倍体细胞（＞5C细胞），仅有Ⅳ组含有异倍体细胞（＞5C细胞）；四组的核长径及短径、核周长、核面积从Ⅰ～Ⅳ组逐渐增加（ P＜0．05），且组间比较有统计学差异（ P＜0．05）。【结论】细胞DNA定量分析技术在乳腺导管非典型增生与癌变鉴别中具有较高诊断价值。

[Objective] To explore the diagnostic value in breast ductal atypical hyperplasia versus cancer by cellular DNA quantitative cytology .[Methods] Four groups of normal breast （Ⅰ group ,n =30） ,ductal mild‐moderate breast ductal atypical hyperplasia （Ⅱ group ,n=22） ,severe dysplasia （Ⅲ group ,n=30） and infiltra‐ting ductal carcinoma （Ⅳ group ,n=42） were collected ,subjected to Feulgen staining and then measured by DNA quantitative cytology .[Results] Obvious statistical differences existed in DNA index （DI） and S phase fraction （SPF） between four groups （I ,Ⅱ ,Ⅲ ＆ Ⅳ） （ P〈0 .05） .And significant differences were also found by compa‐ring different methods （ P 〈0 .05） .DI and SPF increased gradually from Ⅰ to Ⅳ groups .Significant statistical differences existed in the ratios of 2C ,3C‐4C and 5C cells among four groups （ P〈0 .05） .The ratio of 2C cell de‐creased gradually while the ratios of 3C‐4C and 5C cells increased gradually from Ⅰ to Ⅳ groups （ P〈0 .05） .5C cell and DNA aneuploidy were not found in groups I ,Ⅱ and Ⅲ .And DNA aneuploidy only existed in group Ⅳ . Significant differences also existed in nuclear long diameter and short diameter ,perimeter and nuclear area among four groups （ P 〈0 .05） .And each parameter increased gradually from Ⅰ to Ⅳ groups .[Conclusion] Cellular DNA quantitative cytology is vital for an early differential diagnosis of breast ductal atypical hyperplasia versus cancer .