摘要
目的探讨DNA异倍体检测在肺癌筛查和早期诊断中的应用价值。方法对679例肺部疾病患者的支气管镜刷检、活检组织(支气管镜活检、手术切除)标本(280例)及胸腔积液脱落细胞399例经常规处理、HE染色,进行病理学检查,采用Motic全自动细胞DNA定量分析系统检测标本中的DNA异倍体,同时分别测定血清、胸腔积液中肿瘤标志物CEA含量。结果全自动细胞DNA定量分析与组织学检测、细胞学检测及血清癌胚抗原(CEA)检测结果之间比较无统计学差异(P>0.05);DNA异倍体的检测结果与胸腔积液的病理学检测、脱落细胞学检测及血清/胸水CEA等检测结果之间亦无统计学差异(P>0.05)。其中,DNA异倍体检测灵敏度及特异度均略低于常规支气管刷片,而与血清CEA检测结果无差异;胸水中DNA异倍体检测的灵敏度与特异度亦均低于胸水脱落细胞学及胸水CEA检测,但与血清CEA检测结果无差异。同时,DNA异倍体在早期及晚期肺癌的检出结果中未见明显统计学差异(P>0.1)。结论全自动DNA定量分析技术是一种敏感而特异的肺癌的筛查技术;DNA异倍体可能属于肺癌发生的早期事件,检测DNA异倍体有望作为肺癌早期诊断与筛查的有价值的标志物;DNA异倍体与支气管镜刷检或与CEA联合检测可提高肺癌诊断的阳性率。
Objective To investigate the value of DNA heteroploid in screening and early diagnosis of lung cancer. Methods All 280 biopsy samples and 399 exfoliocytology of pleural effusion samples were collected and underwent routine treatment,HE staining and pathological examination. Using Motic automatic cell DNA quantitative analysis system to detect DNA heteroploid in the samples. Meanwhile the carcino embryonie antigen（ CEA） were measured both in serum and pleural effusion. Results There was not a statistical significance in methodology between Motic automatic cell DNA quantitative analysis, cytology examination,histology examination and CEA measurement（ P 0. 05）. The methodology of detecting DNA heteroploid in exfoliocytology,pathology and CEA measurement shows no statistical significance（ P 0. 05）.The sensitivity and specificity of DNA heteroploiddetection was inferior compared with bronchial brushing,but no diffirence with the serum-CEA. The measurement of DNA heteroploid in pleural effusion has a lower sensitivity and specificity than exfoliocytology and pleural effusion-CEA,but no diffirence with serum-CEA.Meanwhile,there is no statistical significance of DNA heteroploid detection both in early stage and advanced stage of lung cancer. Conclusions Automatic cell DNA quantitative analysis can be a screening technology for lung cancer with high sensitivity and specificity. DNA heteroploid may occur in the early genesis of lung cancer and has a hope to become a biomarker for early diagnosis of lung cancer. The combination of DNA heteroploid,bronchial brushing and CEA can enhance the diagnosis rate of lung cancer.
出处
《中华肺部疾病杂志（电子版）》
CAS
2015年第6期18-22,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
西安交通大学医院第二附属医院科研基金资助[YJ(QN)201408]
