【摘要】：目的:通過與液基薄層細胞學技術(shù)(liquid-based cytology,LBC)相比較,探討細胞DNA定量分析技術(shù)(DNA image cytometry,DNA-ICM)在肺癌診斷中的應用價值,尋找肺癌早期診斷的有效方法。方法:采用DNA定量分析技術(shù)和液基薄層細胞學技術(shù)對肺癌組570個標本(其中痰液標本246個,BALF標本226個,纖維支氣管鏡刷片標本98個)和非肺癌組465個標本(其中痰液標本213個,BALF標本205個,纖維支氣管鏡刷片47個)進行比較分析。結(jié)果:DNA-ICM在BALF中檢查的敏感度為71.2%,特異度為100%;LBC在BALF中檢查的敏感度為49.1%,特異度為97.6%。DNA-ICM在痰液中檢查的敏感度為41.9%,特異度為100%;LBC在痰液中檢查的敏感度為22.4%,特異度為98.1%。與LBC相比較,兩種標本DNA-ICM的敏感度均較高(P0.01)。117例同時采集BALF和纖維支氣管鏡刷片的患者中,DNA-ICM在BALF中的敏感度為77.5%,特異度為100%。DNA-ICM在纖維支氣管鏡刷片中的敏感度為58.8%,特異度為100%。DNA-ICM在BALF中的敏感度高于纖維支氣管鏡刷片中的敏感度(P0.05)。在病理組織分型不同的肺癌患者中,DNA-ICM在腺癌中的敏感度為59.8%,DNA-ICM在鱗癌中的敏感度為77.4%。DNA-ICM在鱗癌的敏感度高于腺癌(P0.01)。結(jié)論:細胞DNA定量分析技術(shù)在肺癌診斷中有較大的應用價值,無論是在痰液還是支氣管肺泡灌洗液以及纖維支氣管鏡刷片標本中,細胞DNA定量分析技術(shù)的敏感度均較液基細胞學診斷技術(shù)高,在一定程度上能夠減少漏診率;與LBC聯(lián)合檢查能提高肺癌的陽性診斷率,可作為肺癌早期診斷的新手段,值得推廣應用于臨床。
[Abstract]:Objective: to explore the value of cell DNA quantitative analysis (DNA image cytometry,DNA-ICM) in the diagnosis of lung cancer by comparing with liquid based thin layer cytology (liquid-based cytology,LBC), and to find an effective method for early diagnosis of lung cancer. Methods: a total of 570 lung cancer specimens (including 246 sputum specimens and 226 BALF specimens) were examined by DNA quantitative analysis and liquid-based thin layer cytology. A comparative analysis was made between the fiberoptic bronchoscopic brushes (98 specimens) and non-lung cancer group (sputum (213 specimens), BALF specimens (205 specimens) and fiberoptic bronchoscopy brushes (47 specimens). Results: the sensitivity of DNA-ICM in BALF was 71.2 and the specificity was 100. The sensitivity of LBC in BALF was 49.1, the specificity of 97.6%.DNA-ICM in sputum was 41.9, the specificity of 97.6%.DNA-ICM in sputum was 22.4and the specificity was 98.1. The sensitivity of DNA-ICM in both specimens was higher than that of LBC (P0.01). The sensitivity of DNA-ICM in BALF was 77.5% in 117 patients who collected both BALF and fiberoptic bronchoscopic brushes. The sensitivity of 100%.DNA-ICM in fiberoptic bronchoscopic brushes was 58.8, and the specificity of 100%.DNA-ICM in BALF was higher than that in fiberoptic bronchoscopic brushes (P0.05). In lung cancer patients with different histological types, the sensitivity of DNA-ICM in adenocarcinoma was 59.8%. The sensitivity of 77.4%.DNA-ICM in squamous cell carcinoma was higher than that in adenocarcinoma (P0.01). Conclusion: quantitative analysis of cell DNA is of great value in the diagnosis of lung cancer, both in sputum, bronchoalveolar lavage fluid and bronchofiberscope brush specimen. The sensitivity of quantitative analysis of cell DNA was higher than that of liquid-based cytology, and the rate of missed diagnosis could be reduced to some extent. Combined with LBC can improve the positive diagnosis rate of lung cancer and can be used as a new method for early diagnosis of lung cancer.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R734.2

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