全自动DNA图像分析系统在胰腺恶性肿瘤诊断中的价值

Values of automatic DNA image analyses in diagnosis of pancreatic malignant tumors

目的:评估全自动DNA图像分析(DNA-ICM)系统在诊断胰腺恶性肿瘤中的价值。方法:108例可疑胰腺恶性肿瘤患者行超声内镜引导下细针穿刺,所获标本分别行常规细胞学检测及DNA-ICM检测,以组织病理学诊断结果为标准,参考临床随访资料,分析细胞学、DNA-ICM及两者联合的诊断价值。结果:常规细胞学诊断的敏感性(93.1%)、特异性(95.2%)、阳性预测值(98.8%)、阴性预测值(76.9%)及准确率(93.5%)均高于DNA-ICM(分别为90.8%、90.5%、97.5%、70.4%、90.7%),但两者之间的差异均无统计学意义(P>0.05)。两种方法联合诊断的各项指标分别为敏感性(95.4%)、特异性(90.5%)、阳性预测值(97.6%)、阴性预测值(82.6%)及准确率(94.4%)。两者联合诊断的敏感性、阴性预测值、准确率均高于单独诊断,但其差异均无统计学意义(P>0.05)。结论:DNA-ICM联合细胞学诊断有很好的临床应用价值,DNA-ICM是胰腺细胞学诊断的一种较好的辅助诊断手段。

OBJECTIVE:To evaluate values of automatic DNA image analyses(DNA-ICM)in diagnosisof pancreatic malignant tumors.METHODS:Patients with suspected pancreatic malignant tumor whounderwent endoscopic ultrasonics guided fine needle puncture were recruited for our study.Collected sampleswere tested by conventional cytology and DNA-ICM.Diagnostic values of cytology,DNA-ICM and theircombination were analyzed using histopathological diagnosis as the standard reference to clinical follow-up data.RESULTS:Among the 108 patients,sensitivity,specificity,positive predictive value,negative predictivevalue and accuracy of conventional cytological diagnosis were higher than those of DNA-ICM(93.1%vs90.8%,95.2%vs 90.5%,98.8%vs 97.5%,76.9%vs 70.4%,93.5%vs 90.7%).However,there was nostatistical significance between them(P>0.05).The combined diagnosis indexes for the two methods were95.4%,90.5%,97.6%,82.6%,94.4%,respectively.Sensitivity,negative predictive value and accuracy of thecombined diagnosis were higher than those of single diagnosis,but the differences were not statisticallysignificant(P>0.05).CONCLUSION:DNA-ICM combined cytological diagnosis has great application value,and DNA-ICM showed good auxiliary diagnostic values for pancreatic cytology diagnosis.