细胞DNA定量分析系统在泌尿系统恶性肿瘤筛查中的临床价值

Clinical value of cell DNA image cytometry in the malignant tumors of urinary system screening

目的:探讨细胞DNA定量分析系统(DNA image cytometry,DNA-ICM)在泌尿系统恶性肿瘤筛查中的应用价值。方法:收集620例血尿标本(标本均得到病理或影像或临床诊断证实,其中恶性113例,良性15例,其他非肿瘤性病变492)。同时进行液基细胞学(Liquid-Based Cytology,LBC)方法和DNA-ICM进行检测,比较两者的敏感度和特异度,阳性及阴性预测值。结果:DNA-ICM和LBC的敏感度分别98.68%和87.01%,差异有统计学意义(P<0.05);特异度(99.59%,98.58%)、阳性预测值(98.43%,94.07%)及阴性预测值(99.39%,96.61%)比较差异均无统计学意义(P>0.05)。结论:DNA-ICM在泌尿系统恶性肿瘤诊断中具有明显优势,联合LBC方法可以互为补充,有效降低漏诊率和误诊率,提高诊断准确率,对患者做到早诊断、早治疗。

Objective: To investigate the clinical value of cell DNA image cytometry(DNA-ICM) in the malignant tumors of urinary system screening. Method: Totally 620 hematuria specimens were detected with DNA-ICM and liquid-based cytology(LBC). One hundred and thirteen cases were malignant tumor, 15 patients were benign tumor and 492 cases were non-neoplastic lesion. All patients were confirmed by pathology, iconography or clinical diagnosis. We compared the sensitivity, specificity, positive and negative predictive value between DNA-ICM and LBC. Result: The sensitivity of DNA-ICM was 98.68% in the cancer screening, that of LBC was 87.01%(P<0.05), but no statistical significance was found in the specificity(99.59%, 98.58%), positive predictive value(98.43%, 94.07%) or negative predictive value(99.39%, 96.61%)(P>0.05). Conclusion: DNA-ICM shows superiority in the diagnosis of malignant tumors in the urinary system. Combined with LBC, DNA-ICM could effectively reduce the rate of missed diagnosis and misdiagnosis, improve the diagnostic accuracy, so as to win the opportunity of early diagnosis and treatment for patients.