DNA 定量分析与液基细胞学在胆管良恶性病变中的应用价值
| 作者: |
1颜云
1 扬州大学附属医院病理科，江苏 扬州 225000 |
| 通讯: |
颜云
Email: baiyunzhou999@sina.cn |
| DOI: | 10.3978/j.issn.2095-6959.2019.04.022 |
摘要
目的：对比内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography，ERCP)中胆管刷检液基细胞学、DNA定量分析结果，探讨ERCP胆管刷检液基细胞学及DNA定量分析在胆管疾病诊断中的应用价值。方法：选取ERCP胆管刷检病例同时做液基细胞学诊断及DNA定量分析，将其结果与组织学活检进行对比。结果：胆管刷检液基细胞学诊断恶性肿瘤41例，疑癌10例，核异质42例，阴性91例；DNA定量分析诊断见异倍体细胞102例，阴性82例；病理活检诊断癌90例，异型增生22例，阴性72例。液基细胞学诊断灵敏度、特异度分别为66.1%与70.8%。DNA定量分析的灵敏度、特异度分别为84.8%与95.8%。液基细胞学的诊断准确性为67.9%，DNA定量分析的诊断准确性为88.6%。DNA定量分析诊断的准确性、灵敏度及特异度较液基细胞学诊断高，二者比较差异有统计学意义(P<0.05)。结论：液基细胞学及DNA定量分析联合检测能提高胆道疾病的检出率，降低漏诊及误诊的风险。
关键词：
内镜逆行胆管造影术；刷检；液基细胞学；DNA定量分析
Application value of DNA quantitative analysis and liquid based cytology in benign and malignant biliary duct lesions
CorrespondingAuthor: YAN Yun Email: baiyunzhou999@sina.cn
DOI: 10.3978/j.issn.2095-6959.2019.04.022
Abstract
Objective: To compare the liquid-based cytology and DNA quantitative analysis of bile duct brushing in endoscopic retrograde cholangiopancreatography (ERCP), and to explore the value of ERCP liquid-based cytology and DNA ploidy analysis in the diagnosis of bile duct diseases. Methods: Cholangio-brushing cases of ERCP were selected for liquid-based cytological diagnosis and DNA quantitative analysis, and the results were compared with histological biopsy. Results: A total of 41 malignant tumors, 10 suspected cancers, 42 nuclear heterogeneity and 91 negative cases were diagnosed by liquid-based cytology of bile duct brush examination; 102 aneuploid cells and 82 negative cases were diagnosed by DNA quantitative analysis; 90 cancer cases were diagnosed by pathological biopsy, 22 dysplasia cases and 72 negative cases. The sensitivity and specificity of liquid-based cytology were 66.1% and 70.8%, respectively. The sensitivity and specificity of DNA quantitative analysis were 84.8% and 95.8%, respectively. The diagnostic accuracy of liquid-based cells was 67.9%, and that of DNA quantitative analysis was 88.6%. The diagnostic accuracy, sensitivity and specificity of DNA quantitative analysis were higher than those of liquid-based cytology (P<0.05). Conclusion: The combined detection of liquid-based cytology and DNA quantitative analysis can improve the detection rate of biliary tract diseases and reduce the risk of missed diagnosis and misdiagnosis.
Keywords：
endoscopic retrograde cholangiography; brushing; liquid-based cytology; DNA quantitative analysis