DNA倍体分析在支气管恶性肿瘤中的诊断价值

Clinical Value of DNA Ploidy Analysis in the Diagnosis of Bronchial Malignancy

摘要: 目的：探讨DNA倍体分析配合常规脱落细胞学在支气管恶性肿瘤诊断中的临床意义，寻找对支气管恶性肿瘤，特别是肿瘤早期诊断的理想方法。方法：收集2017年1月~2019年6月我院病理科经活检证实的123例支气管恶性肿瘤患者支气管脱落细胞合格标本作为实验组，235例非恶性肿瘤及上皮内瘤变患者支气管脱落细胞合格标本为对照组，分别进行DNA倍体分析及脱落细胞学检查。结果：支气管脱落细胞检查的特异性高于DNA倍体分析，敏感性低于DNA倍体分析。其总体敏感性为79.67%，总体特异性为98.74%，DNA倍体分析对支气管恶性肿瘤诊断的总体敏感性为100%，总体特异性为97.02%。在支气管恶性肿瘤及不同级别上皮内瘤变中，DNA倍体分析的敏感性明显高于支气管脱落细胞学检查，尤其是对支气管恶性肿瘤及高级别上皮内瘤变的敏感性极高，均大于98.37%。结论：DNA倍体分析对支气管恶性肿瘤或上皮内瘤变诊断的敏感性及重复性均较好，但特异性不足。如结合脱落细胞学检查，可提高支气管恶性肿瘤，特别是肿瘤早期或高级别上皮内瘤变的检出率或准确率，防止误诊及漏诊，是支气管脱落细胞学检测很好的补充。

Abstract: Objective: To explore the clinical value of DNA ploidy analysis combined with conventional abscis-sion cytology in the diagnosis of bronchial malignant tumors, and find an ideal method for early di-agnosis of bronchial malignant tumors. Methods: A total of 123 patients with bronchial malignant tumor confirmed by biopsy admitted to our hospital from January 2017~June 2018 were enrolled in the observation group, and 235 patients with non-malignant tumor and intraepithelial neoplasia were enrolled in the control group. Both groups received DNA ploidy and bronchofiberscope brush smear cytology analysis. Results: The specificity of bronchial exfoliocytology was higher than DNA ploidy analysis, but the sensitivity was lower than DNA ploidy analysis. The overall sensitivity and specificity were 79.67% and 98.74%, respectively. The overall sensitivity and specificity of DNA ploidy analysis for the diagnosis of bronchial malignancy were 100% and 97.02% respectively. The sensitivity of DNA ploidy analysis was significantly higher than that of exfoliocytology in bron-chial malignancy and different grades of intraepithelial neoplasia, especially in bronchial malig-nancy and high-grade intraepithelial neoplasia, both of which were highly sensitive (>98.37%). Conclusion: DNA ploidy analysis showed good sensitivity and repeatability in the diagnosis of bronchial malignancy or intraepithelial neoplasia, but less specificity. If combined with exfolio-cytology, detection rate and accuracy of bronchial malignant tumor can be highly improved, espe-cially in the early stage or high-grade intraepithelial neoplasia. Thus, DNA ploidy analysis is a good complement to the detection of bronchial exfoliocytology to prevent misdiagnosis and missed di-agnosis.