作者:刘洋,高岩,陈学杰,华红
关键字:DNA 定量分析;口腔鳞状细胞癌;口腔潜在恶性疾病;口腔扁平苔藓; 口腔白斑病
摘要:
北大口腔-脱落细胞DNA定量分析在口腔潜在恶性疾病诊断中的准确性_刘洋.pdf
[摘要] 目的:探讨口腔黏膜脱落细胞DNA 定量分析在筛查口腔鳞状细胞癌(oral squamous cell carcinoma, OSCC)及口腔潜在恶性疾病(oral potential malignant disorders, OPMDs)的准确性。方法:对203 例口腔黏膜病患者进行组织病理学检查和DNA 定量分析检测,以组织病理学检查为金标准,评价DNA 定量分析诊断的灵敏度、特异度、Youden 指数、阳性似然比、阴性似然比、阳性预测值、阴性预测值等。结果:共纳入组织病理学检查为OSCC 和原位癌 (tumor in situ,TIS)的患者46 例,白斑(oral leukoplakia, OLK)上皮异常增生患者39 例,疣
状白斑伴基底细胞增生活跃1 例,白斑单纯增生29 例,口腔扁平苔藓(oral lichen planus, OLP)83 例,炎症5 例。以组织病理学诊断结果为金标准,以OSCC,TIS和上皮异常增生为阳性组,其他为阴性组,DNA 定量分析系统诊断的灵敏度为79.07%,特异度为81.20,准确度为80.30%;诊断OSCC 和TIS 的灵敏度95.65%,特异度81.20%,诊断准确度为85.28%;诊断上皮异常增生时,DNA 定量分析系统诊断的灵敏度60.00%,特异度81.20%,诊断准确度为75.8%。结论:DNA 定量分析诊断操作微创,简便,可以作为OSCC 及OPMDs 的筛查方法以及OSCC术后随访的辅助监测手段。
作者:O. G. Wong, M. W. Ho, O. K. Tsun, A. K. Ng, E. Y. Tsui, J. N. Chow1,A. N. Cheung
关键字:automated DNA-image-cytometry, cervical cancer, DNA ploidy, HPV DNA test, screening
摘要:
Objective: To evaluate the performance of an automated DNA-image-cytometry system as a tool to detect cervical carcinoma.
Methods: Of 384 liquid-based cervical cytology samples with available biopsy follow-up were analyzed by both the Imager System and a high-risk HPV test (Cobas).
Results: The sensitivity and specificity of Imager System for detecting biopsy proven high-grade squamous intraepithelial lesion (HSIL, cervical intraepithelial neoplasia[CIN]2-3) and carcinoma were 89.58% and 56.25%, respectively, compared to 97.22% and 23.33% of HPV test but additional HPV 16/18 genotyping increased the specificity to 69.58%. The sensitivity and specificity of the Imager System for predicting HSIL+ (CIN2-3+) lesions among atypical squamous cells of undetermined significance samples were 80.00% and 70.53%, respectively, compared to 100% and 11.58% of HPV test whilst the HPV 16/18 genotyping increased the specificity to 77.89%. Among atypical squamous cells-cannot exclude HSIL, the sensitivity and
specificity of Imager System for predicting HSIL+ (CIN2-3+) lesions upon follow up were 82.86% and 33.33%%, respectively, compared to 97.14% and 4.76% of HPV test and the HPV 16/18 genotyping increased the specificity to 19.05%. Among low-grade squamous intraepithelial lesion cases, the sensitivity and specificity of the Imager System for predicting HSIL+ (CIN2-3+) lesions were 66.67% and 35.71%%, respectively, compared to 66.67% and 29.76% of HPV test while HPV 16/18 genotyping increased the specificity to 79.76%. The overall results of imager and highrisk HPV test agreed in 69.43% (268) of all samples.
Conclusions: The automated imager system and HPV 16/18 genotyping can enhance the specificity of detecting HSIL+ (CIN2-3+) lesions.
作者:刘春雷,李晓莹,马瑛泽,段金雨,王春靖,黄维丽,杨志平,关晓辉
关键字:食管癌; DNA 定量检测; 早期诊断
摘要:
摘要: 目的探究食管黏膜细胞定量检测DNA 在早期食管癌诊断中的应用。方法选取我院2017年1 月-2017年12月于我院行胃镜检查的患者80 例,正常体检胃镜患者20 例,分别对这些患者行DNA 定量检测分析、常规活检病理检查。结果本实验DNA 定量检测敏感性为94.0%,特异性为81.0%; 常规活检病理检查敏感性为73.8%,特异性为26.3%; DNA 定量检测与常规活检病理检查相比,具有统计学意义( P<0.05) 。结论DNA 定量检测在食管癌的早期诊断中具有重要意义,具有临床研究和应用价值。
作者:杨新,方三高,马强,毛成毅,肖华亮
关键字:甲状腺疾病; 甲状腺癌; DNA 定量分析; 冷冻切片; 诊断
摘要:
[摘要] 目的研究细胞DNA 定量分析技术在甲状腺术中冷冻组织印片病理诊断中的准确性。方法收集术中快速冷冻诊断的甲状腺新鲜标本做细胞印片,采用Fealgon 染色,用细胞DNA 自动分析系统扫描并分析1284 例甲状腺及甲状旁腺疾病标本,比较分析术中快速冷冻HE 染色、DNA 定量分析以及术后常规石蜡诊断3 种方法。结果304 例确诊为恶性或可疑恶性( 即阳性) 病例中, 73 例可见大量异倍体细胞, 226 例为可见中等量异倍体细胞,4例可见少量异倍体细胞,1例未见异倍体细胞。阴性或未见明显恶性病例中, 878 例DNA 定量分析结果为未见异
倍体细胞, 61 例可见中等量异倍体细胞, 41 例可见少量异倍体细胞。甲状腺冷冻诊断阳性率23. 7% ( 304 /1284) ,DNA 定量分析诊断的阳性检出率28% ( 360 /1284) ; 术后常规石蜡诊断为恶性的315 例,阳性率24. 5% ( 315 /1284) 。DNA 定量诊断和冷冻诊断与常规石蜡的一致率分别为95. 3%、97. 7%。结论甲状腺细胞DNA 定量分析的诊断结果准确率高,三者结合,可提高甲状腺疾病的诊断准确率。
作者:杨玉涛,王小伟,钟美,李忠礼,李志义,饶家秋
关键字:细胞DNA;倍体定量分析;乳腺癌筛查
摘要:
摘要:目的比较和评估两种乳腺癌筛查方法的应用价值。方法选取贵阳中医学院第二附属医院及贵阳市第一人民医院2015年01月至2015年12月自愿参加乳腺癌筛查并有活检结果的253例病例进行研究。253例乳腺包块住院患者,诊断医师进行针吸穿刺后每例制成2张薄层涂片,1张涂片做巴氏染色,用于常规细胞学检查。另1张经Feulgen染色,用自动细胞DNA定量分析系统检测,每例均有病理结果证实。结果以活检结果作为金标准,253例中共有180例为乳腺良性肿瘤,7例为非典型增生及原位癌,66例为恶性。采用细胞DNA定量分析检测的敏感性和特异性分别为93.15%与95.89%,而常规细胞学检测的敏感性和特异性分别为80.82%与100%。同一个标本同时采用两种方法联合检测,敏感性可提高到94.52%。结论细胞DNA定量分析技术可与常规细胞学联合开展,应用在乳腺癌筛查中。
作者:张筱茵 赵敏 付欣,杨莉,杨巧,刘娜,郭长存,柯小茹,王新,郭学刚,吴开春,樊代明,张宏博
关键字:胰腺肿瘤; 病理学; DNA 探针; 细胞诊断学
摘要:
【摘要】 目的 对比细胞病理学、全自动DNA 定量分析技术及两法联合对胰腺恶性肿瘤内镜超声引导下细针抽吸术(EUS-FNA)标本的诊断价值,并探索DNA 定量分析诊断胰腺恶性肿瘤的诊断截断点。方法 回顾性收集140 例可疑胰腺恶性肿瘤患者的145 份EUS-FNA 标本的细胞病理学及全自动DNA 定量分析结果,以术后病理结合临床随访结果为金标准,统计两种方法及两法联合对胰腺恶性肿瘤的诊断符合率。结果 全自动DNA 定量分析技术诊断胰腺恶性肿瘤的灵敏度(63.0%比82.4%)及准确率(69.7%比85.5%)低于细胞病理学,两法联合诊断胰腺恶性肿瘤的曲线下面积明显高于单一细胞病理学(0.941 比0.912,P=0.0070)或DNA 定量分析
(0.941 比0.815,P<0.0001),差异具有统计学意义。利用约登指数,当全自动DNA 定量分析出至少1 个细胞DNA 指数≥2.5时即可提示为恶性肿瘤。利用该截断值诊断时,全自动DNA 定量分析的灵敏度和准确率可提高至72.3%和77.2%,两法联合灵敏度和准确率可分别提高至91. 6%和93.1%。结论 全自动DNA 定量分析EUSFNA标本是一种省时、有效和客观的诊断恶性肿瘤技术。尽管其诊断价值低于传统的细胞病理学,但是两种方法联合可明显提高诊断符合率。
作者:吴崑岚,丁康,张辉,方媛,林慧萍,章秀,马云,耿建祥
关键字:异倍体;定量分析;结直肠癌;病理学诊断
摘要:
摘要:目的:探讨DNA定量分析技术在结直肠癌诊断中的应用价值。方法:采用DNA定量分析技术对176例正常及结直肠肿瘤患者肠道组织进行异倍体的检测,并以病理学诊断结果作为“金标准”,分析该检测用于诊断的准确性。通过ROC曲线评估该方法的诊断价值。结果:结直肠组织中异倍体的数量和结直肠癌密切相关,癌组织中异倍体的数量明显高于息肉及正常组织,差异有统计学意义(P<0.05)。发现结直肠癌的灵敏度为91.8%,特异度为92.0%,以出现9个以上异倍体为诊断阈值的灵敏度为69.9%,特异度为100.0%,此项技术用于结直肠癌的早期诊断有较高准确性。对异倍体预测发生息肉及结直肠癌风险的准确性进行分析,结果显示预测模型有一定的意义,总体来看,≥9个异倍体发生结直肠癌的预测正确的可能性为94%。结论:异倍体定量分析方法对结直肠癌组织的诊断价值极高,可以临床推广,其诊断阈值需扩大样本量进一步验证。
作者:Alfred H. B?cking, David Friedrich, Dietrich Meyer-Ebrecht, Chenyan Zhu, Anna Feider, Stefan Biesterfeld
关键字:automated cytology; DNA cytometry; DNA image cytometry; DNA karyometry; nuclear classifiers; serous effusions.
摘要:
BACKGROUND: The average sensitivity of conventional cytology for the identification of cancer cells in effusion specimens is only approximately 58%. DNA image cytometry (DNA-ICM), which exploits the DNA content of morphologically suspicious nuclei measured on digital images, has a sensitivity of up to 91% for the detection of cancer cells. However, when performed manually, to our knowledge to date, an expert needs approximately 60 minutes for the analysis of a single slide. METHODS: In the current study, the authors present a novel method of supervised machine learning for the automated identification of morphologically suspicious mesothelial and epithelial nuclei in Feulgen-stained effusion specimens. The authors compared this with manual DNA-ICM and a gold standard cytological diagnosis for 121 cases. Furthermore, the authors retrospectively analyzed whether the amount of morphometrically abnormal mesothelial or epithelial nuclei detected by the digital classifier could be used as an additional diagnostic marker. RESULTS: The presented semiautomated DNA karyometric solution identified more diagnostically relevant abnormal nuclei compared with manual DNA-ICM, which led to a higher sensitivity (76.4% vs 68.5%) at a specificity of 100%. The ratio between digitally abnormal and all mesothelial nuclei was found to identify cancer cell–positive slides at 100% sensitivity and 70% specificity. The time effort for an expert therefore is reduced to the verification of a few nuclei with exceeding DNA content, which to our knowledge can be accomplished within 5 minutes. CONCLUSIONS: The authors have created and validated a computerassisted bimodal karyometric approach for which both nuclear morphology and DNA are quantified from a Feulgenstained slide. DNA karyometry thus increases the diagnostic accuracy and reduces the workload of an expert when
compared with manual DNA-ICM. Cancer Cytopathology 2018;0:1-8. © 2018 The Authors. Cancer Cytopathology published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium,
provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
作者:徐建平,叶伟,赵洁婷,宋蓉蓉,聂琨,吕莉萍
关键字:胸科恶性肿瘤; DNA-ICM; 细胞倍体分析
摘要:
摘要: 目的通过对DNA 图像分析( DNA image cytometry,DNA-ICM) 技术在胸科恶性肿瘤病变诊断应用的研究,寻找该技术在相关病变诊断方面潜在的优势。方法选取安徽省胸科医院2015 年5 月~ 2017 年5 月间送检的4 402 例胸科疾病患者,选取其中701 例符合要求的标本进行DNA-ICM 计算机扫描与自动分析,根据分析结果区分阳性、可疑、阴性诊断,与活检结果及临床基线数据进行对比分析。结果明确恶性肿瘤病变患者的细胞倍体出现异常者可达65%,未明确诊断恶性肿瘤但提示有恶性可能的患者细胞倍体异常率为64%,而在非恶性肿瘤病变患者中则仅为8%。综合评估显示,细胞DNA 倍体诊断的敏感性、特异性、阳性预测值、阴性预测值分别为73%、93%、71%、94%。OR 分析发现恶性肿瘤病变比非恶性肿瘤病变引起倍体异常的风险比是23. 236。结论DNA-ICM 技术对于胸科常见恶性肿瘤诊断有重要的临床应用价值。
作者:魏世蓉,王秋实,杨新,朱祥风,肖华亮
关键字:尿; 脱落细胞; 细胞学; DNA 定量分析
摘要:
[摘要] 目的探讨细胞DNA 定量分析技术在尿脱落细胞学鉴别诊断中的临床价值,提高临床尿路上皮癌的确诊率。方法选择395 例泌尿系统疾病患者,分别采用尿脱落细胞薄层细胞学(TCT) 和Feulgen 染色的细胞DNA定量分析技术( DNA-ICM) 进行检测,并将两种结果进行对比,对其中检查结果异常的患者进行组织学活检。结果细胞DNA-ICM 在尿路上皮癌诊断中的检出率、敏感度、特异性分别为48. 9% ( 192 /395) 、94. 6% ( 192 /203) 、51. 4%( 203 /395) ,TCT 的阳性率、敏感度、特异性分别为28. 1% ( 110 /395) 、38. 4% ( 110 /285) 、72. 2% ( 285 /395) ,
DNA-ICM 检测的敏感度高于TCT 的敏感度,二者比较差异显著( P < 0. 01) 。活检结果显示,DNA-ICM 对癌、疑癌、异型细胞患者的诊断符合率分别为97. 2%、91. 3%、80. 1%。结论细胞DNA-ICM 在尿路上皮癌的诊断中有很好的应用价值,与TCT 联合检测可明显提高尿脱落细胞的临床检出率和准确性,减少漏检的发生。
作者:杨文章 ,张爱华
关键字:脱落细胞;TPS ;CA125 ;口腔癌
摘要:
摘要:目的 分析脱落细胞联合组织多肽特异性抗原(TPS) 、CA125 检测在早期口腔癌诊断中的应用价值。方法 选择2012 年10 月至2017 年10 月,本院收治的经病理确诊的口腔癌和癌前病变共79 例,其中口腔癌患者39 例,癌前病变40 例,同时期健康志愿者40 例。所有研究对象,均行脱落细胞学检查、血清TPS 、CA125 含量检测。结果 早期口腔癌组TPS 及CA125 水平显著高于癌前病变组和对照组(P< 0 .05) ;同时早期口腔癌组TPS 及CA125 阳性率也显著高于癌前病变组( P < 0 .05 ) 。脱落细胞DNA 定量结果显示,早期口腔癌组的阳性率明显高于癌前病变组(χ2 = 53 .766 ,P<0.05) 。脱落细胞联合TPS 、CA125 含量检测的检出率及阳性预测值均显著高于TPS 、CA125 含量(χ2 = 5 .556 ,8.919 ;P< 0 .05) ,略高于脱落细胞检测(P > 0 .05) 。结论 脱落细胞联合TPS 、CA125 检测可有效提高早期口腔癌的检出率,利于口腔癌患者的预防及治疗。
作者:石安琪王敏向莱江涛
关键字:肺癌; DNA 定量分析; 肺泡灌洗液
摘要:
【摘要】目的探讨全自动DNA 定量分析在肺泡灌洗液中的应用价值。方法收集合格肺泡灌洗液
标本386 例,同时送检液基细胞学检查及全自动DNA 定量分析检查,并随访病检结果、肺癌病例分期结果。结果共168 例有明确病理学证据诊断为肺癌,其中52 例未发现异倍体细胞; 218 例标本未找到明确病理学肿瘤证据,其中43 例找到异倍体细胞。DNA-ICM 与病理学对肺泡灌洗液的诊断价值差异具有统计学差异( P< 0. 05) 。非小细胞肺癌病例中,细胞DNA 含量与肿瘤分期呈正相关,相关系数为3. 28,P < 0. 001; 与肿瘤部位、肿瘤类型无明显相关性。结论DNA-ICM 检查对肺癌的诊断价值不及病理学检查,但细胞DNA 含量与肿瘤分期呈正相关,可协助评估肿瘤预后。
作者:ANQI SHI, WANG MIN, LAI XIANG, WU XU and TAO JIANG
关键字:lung cancer, diagnosis, DNA image cytometry, liquid?based cytology, bronchoalveolar lavage fluid, pleural effusion
摘要:
Abstract. The present study aimed to investigate the diagnostic value of automatic DNA image cytometry (DNA‑ICM) for diagnosing lung cancer. A total of three different types of samples from 465 cases were included: Bronchoalveolar lavage fluid (BALF), 386 samples; pleural effusion cases, 70 samples; and fine‑needle aspiration procedures, 9 samples. Two methods, liquid‑based cytology (LBC) and automatic DNA‑ICM, were used to assess the samples, and the pathological results of 120/465 cases were reviewed. The results of DNA‑ICM were compared with those of LBC and pathology. There were 57 cases of lung cancer without aneuploidy and 49 cases without evidence of malignant tumor, but with the presence of heteroploid cells. The positive diagnostic rate for BALF samples using LBC was significantly higher compared with that for DNA‑ICM (P<0.05). No statistically significant difference was observed in the positive diagnostic rate between DNA‑ICM and LBC in pleural effusion samples. For DNA‑ICM in BALF, pleural effusion and all samples, no statistically significant differences were identified between the positive diagnostic rates of lung squamous carcinoma and lung adenocarcinoma. The positive diagnostic rate of LBC combined with DNA‑ICM was not significantly improved. In non‑small cell lung cancer (NSCLC) cases, the difference in the maximum value of DNA (DNAmax) was positively correlated with tumor stage (P<0.05), but no significant correlations were observed among DNA max, tumor type and tumor location. In small‑cell lung cancer (SCLC) cases, no significant correlations were observed among DNAmax, tumor staging or tumor location. The differences in the DNAmax values of squamous cell carcinoma, adenocarcinoma, SCLC and NSCLC were not statistically significant. In the present study, the area under the receiver operating characteristic curve for LBC (0.936) was significantly greater compared with that for DNA‑ICM (0.766) (P<0.05). DNA‑ICM has medium diagnostic value in lung cancer, and the DNAmax was positively correlated with tumor stage in NSCLC. DNA‑ICM may serve as a supplement to LBC, but it is not recommended as a sole procedure for lung cancer screening.
作者:华诏召曾莉曹俊岩熊薇罗德毅张向华刘璇程力
关键字:子宫腔脱落细胞;DNA倍体分析;子宫内膜病变;筛查
摘要:
[摘要]目的探讨子宫腔脱落细胞的DNA倍体分析技术应用于子宫内膜病变筛查的可行性及应用价值。方法选取2014年1月~2016年5月就诊于贵阳中医学院第二附属医院疑似子宫内膜病变患者500例为研究对象.采集子宫腔脱落细胞标本,采用Feulgen染色和全自动DNA倍体分析系统分析患者DNA倍体情况,同时行分段诊断性刮宫术检测,以分段诊断性刮宫术检测结果为金标准,观察DNA倍体分析对诊断子宫内膜病变的敏感性和特异性。结果分段诊断性刮宫术检测发现,子宫内膜癌39例(78.0%),癌前病变98例(19.6%),子宫内膜量增生258例(51.6%),正常子宫内膜105例(21.0%)。子宫腔脱落细胞DNA倍体分析子宫内膜癌检出率相似于病理检
查,差异无统计学意义(P>0.05);子宫腔脱落细胞DNA倍体分析癌前病变检出率相似于病理检查.差异无统计学意义(|P>0.05)。以病理活检结果为金标准,DNA倍体分析筛查子宫内膜病变的敏感性、特异性、准确度分别为92.7%、83.8%、86.2%,DNA倍体分析筛查子宫内膜癌的敏感性、特异性、准确度分别为94.9%、67.7%、69.8%。结论DNA倍体分析对子宫内膜癌的筛选敏感性高,可用于子宫内膜病变的早期筛查,具有一定临床推广价值。
作者:王飞霞,杨瑞利,韩双
关键字:细胞DNA 定量分析;高危型HPV;鳞状细胞相关抗原;细胞角蛋白19 片段;宫颈癌
摘要:
摘要:[目的] 探讨宫颈细胞DNA 定量分析联合高危型人乳头瘤病毒(HR-HPV)、鳞状细
胞相关抗原(SCCA)、细胞角蛋白19 片段(CYFRA21-1)检测在早期宫颈癌筛查中的价值。[方法] 采用细胞DNA 倍体定量分析、实时荧光PCR 法及电化学发光法对84 例宫颈癌患者、92例宫颈良性病变者和92 例健康对照者的宫颈细胞DNA 倍体、高危型HPV 及肿瘤标志物
SCCA、CYFRA21-1 进行检测,以病理诊断为标准对其单独和联合检测的诊断效能进行评价。
[结果] 宫颈癌组细胞DNA 倍体、HPV、SCCA、CYFRA21-1 的阳性率明显高于宫颈良性疾
病组和健康对照组(P<0.05);联合检测的敏感度、特异性、诊断符合率、阳性预测值、阴性预测值、Youden 指数等都明显提高,其中四项联合检测诊断宫颈癌的敏感度为97.62%,特异性为99.44%, 诊断符合率达98.86%,Youden 指数为0.971, 高于任一单项指标和其他联合方式。[结论] 宫颈细胞DNA 定量分析联合HR-HPV、SCCA、CYFRA21-1 检测具有高敏感度、高特异性和高准确性的特点,在宫颈癌早期筛查中有较高的应用价值。
作者:梁建
关键字:DNA 定量分析;宫颈病变;筛查;应用价值
摘要:
[摘要] 目的探究DNA 定量分析检查于宫颈病变筛查中的应用价值。方法整群选取该院2014 年1 月—2016 年1 月的4 213 例患者做DNA 倍体检测与宫颈液基细胞学检查,其中的138 例液基细胞学阳性与DNA 异倍体者做宫颈活检,总结DNA 倍体检测于宫颈疾病筛查中的应用价值。结果4 213 例患者中,液基细胞学的阳性检出率为4.1%(共计171 例),DNA 异倍体细胞检出率为4.9%(共计206 例),检出率的对比提示差异有统计学意义(P<0.05);在DNA 异倍体细胞检出增多的同时、液基细胞学阳性检出率也随之升高。234 例DNA 异倍体与液基细胞检查阳性者中有138 例进行活检,少量、中量以及大量DNA 倍体异常者检出率分别是8.7%、48.6%、41.3%;以DNA 异倍体出现为活检标准,宫颈病变敏感性是98.6%。结论DNA 倍体检测具有精准、快速、客观的应用优点,可作为宫颈疾病筛查的的有效工具在临床做积极推广。