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目的 :探讨鼻咽细胞学检查结合DNA核型判断和细胞EB病毒检测在可疑鼻咽癌病人筛查中的作用。方法 :分别对 6 6例可疑鼻咽癌就诊病人作鼻咽刷片细胞学诊断和应用CAS2 0 0图像分析仪测定涂片细胞DNA含量 ,细胞学癌阳性病例同时作EB病毒编码RNA(EBERs)原位杂交。结果 :与组织学诊断相比 ,细胞学诊断和DNA非二倍体诊断癌的敏感性分别为6 6 %和 5 5 % ,两者结合判断不能提高敏感性 ,并且假阴性率高 ;细胞学癌阳性病例的癌细胞核EBERs阳性率 92 .1% ,其中 6例DNA二倍体核型病例均呈EBERs阳性 ,可诊断为鼻咽癌。结论 :鼻咽细胞学检查结合DNA核型判断不能提高可疑鼻咽癌病人的诊断率 ,不适用于鼻咽癌筛查。细胞涂片的EB病毒原位杂交方法 ,在鼻咽癌可疑病人的诊断和鉴别诊断上具有重大实用价值 ,在鼻咽癌筛查的作用有待进一步研究
Objective: To investigate the role of nasopharyngeal cytology in combination with DNA karyotype determination and Epstein-Barr virus detection in screening patients with suspected nasopharyngeal carcinoma. Methods: Sixty-six cases of suspected nasopharyngeal cancer patients were diagnosed as nasopharyngeal brush cytology and the Epstein-Barr virus-coding RNA (EBERs) were detected by CAS2 0 0 image analyzer. In situ hybridization. Results: Compared with histological diagnosis, cytological diagnosis and DNA non-diploid diagnosis of cancer sensitivity were 6 6% and 5 5%, both combined with the judge can not increase the sensitivity and false negative rate; cytology The positive rate of EBERs in cancer-positive cases was 92.1%, of which 6 cases of DNA diploid karyotypes were EBERs-positive and could be diagnosed as nasopharyngeal carcinoma. Conclusion: Nasopharyngeal cytology combined with DNA karyotype judgment can not improve the diagnostic rate of suspected NPC patients, so it is not suitable for NPC screening. Cell smear of the EB virus in situ hybridization in the diagnosis and differential diagnosis of suspicious patients with nasopharyngeal carcinoma has great practical value in the role of nasopharyngeal carcinoma screening needs further study