痰液细胞DNA定量分析在原发性肺癌中的诊断价值

Application of DNA-image cytometry in the diagnosis of primary lung cancer in sputum samples

目的:探讨痰液细胞DNA定量分析技术(DNA-ICM)在原发性肺癌诊断中的临床意义。方法:分别采用细胞DNA-ICM和液基细胞学技术(LBC)对300例可疑肺癌患者痰液进行检查,并将结果进行比较分析。结果:细胞DNA-ICM在痰液中的阳性检出率为37.3%(112/300), LBC在痰液中的阳性检出率为21.0%(63/300),差异有统计学意义(P<0.01)。两种方法联合检查的痰检阳性率为38.7%(116/300),高于LBC,差异有统计学意义(P<0.01);也高于DNA-ICM,但差异无统计学意义(P>0.05)。细胞DNA-ICM的敏感度为42.6%(112/263),特异度为100%(37/37);LBC敏感度为23.2%(61/263),特异度为94.6%(35/37),细胞DNA-ICM的敏感度高于LBC,差异有统计学意义(P<0.01)。在病理组织分型不同的肺癌患者中,DNA-ICM在鳞癌中的敏感度高于腺癌(P<0.01)。DNA-ICM在早期肺癌及晚期肺癌检查结果中无统计学差异(P>0.05)。结论:细胞DNA-ICM技术是一种敏感而特异的肺癌筛查技术,在肺癌早期诊断方面具有一定优势,可与LBC联合应用于肺癌的筛查。

Objective:To explore the value of DNA image cytometry(DNA-ICM) applied to sputum cytology in lung cancer diagnosis.Methods:300 cases of doubtful primary lung cancer patients who respectively underwent DNA image cytometry and liquid-based cytology(LBC) were collected and the related pathological data were analyzed.Results:The positive detection rate of DNA-ICM in sputum was 37.3%,while the positive detection rate of LBC in sputum was 21.0%.The positive detection rate of DNA-ICM was significantly higher than that of method of LBC in the diagnose of primary lung cancer(P<0.01).The positive detection rate was 38.7% by combining LBC and DNA-ICM.The positive detection rate by combining LBC and DNA-ICM was significantly higher than that of method of LBC.The positive detection rate by combining LBC and DNA-ICM was also significantly higher than that of method of DNA-ICM.However,this did not have statistical significance(P>0.05).The sensitivity and specificity of DNA-ICM were 42.6% and 100%.And which of LBC were 23.2% and 94.6%,respectively.The sensitivity of DNA-ICM was significantly higher than that of method of LBC(P<0.01).The sensitivity of DNA-ICM in squamous carcinoma was higher that of adenocarcinoma in diffierent histopathological results(P<0.01).Meanwhile,there was no statistical significance of DNA heteroploid detection both in early stage and advanced stage of primary lung cancer(P>0.05).Conclusion:DNA-ICM can be a screening technology for lung cancer with high sensitivity and specificity,which has obvious superiority.DNA-ICM is worth of clinical popularization with liquid-based cytology.