目的 探讨细胞图像DNA倍体分析（DNA-ICM）在恶性胸腔积液病理诊断中的应用价值。 方法 回顾性病例系列研究。回顾性分析山西白求恩医院2021年10月至12月101例胸腔积液患者的临床资料，对胸腔积液标本进行液基细胞学检查（LBC）和DNA-ICM，结合患者的临床诊断、影像学检查、活组织检查和随访结果，比较两种方法的灵敏性和特异性。 结果 101例患者的胸腔积液中，恶性胸腔积液39例，良性胸腔积液62例。LBC和DNA-ICM诊断胸腔积液中恶性肿瘤细胞的灵敏度分别为74.7%和94.9%，特异度分别为98.4%和83.9%；二者联合比单独LBC诊断阳性率提高[36.6%（37/101）比28.7%（29/101）]。对7例DNA-ICM阳性但LBC结果为阴性病例进行随访，其中1例诊断为小细胞肺癌。 结论 DNA-ICM可有效提高胸腔积液细胞学阳性检出率，DNA-ICM和LBC联合检测可降低细胞学漏诊率，对恶性胸腔积液病理诊断具有重要的临床价值。 Objective To explore the clinical application value of DNA image cytometry ploidy analysis (DNA-ICM) in the pathological diagnosis of malignant pleural effusion. Methods A retrospective case series study was conducted. The clinical data of 101 patients with pleural effusion from October to December 2021 in Shanxi Bethune Hospital were retrospectively analyzed. Liquid-based cytology (LBC) and DNA-ICM were performed on pleural effusion specimens. The sensitivity and specificity of the two methods were compared with the clinical diagnosis, imaging, biopsy, and follow-up results of the patients. Results Among the pleural effusions of 101 patients, 39 were malignant pleural effusions and 62 were benign pleural effusions. The sensitivity of LBC and DNA-ICM in diagnosing malignant tumor cells in pleural effusions was 74.7% and 94.9%, respectively, and the specificity was 98.4% and 83.9%, respectively the combination of the two had an increased diagnostic positivity rate compared with that of LBC alone [36.6% (37/101) vs. 28.7% (29/101)]. Seven cases with positive DNA-ICM but negative LBC result were followed up, and 1 case was diagnosed as small cell lung cancer. Conclusions DNA-ICM can effectively improve the positive cytology detection rate of pleural effusion, and the combined detection of DNA-ICM and LBC can reduce the underdiagnosis rate of cytology, which is of great clinical value in the pathological diagnosis of malignant pleural effusion.
Abstract
Objective To explore the clinical application value of DNA image cytometry ploidy analysis (DNA-ICM) in the pathological diagnosis of malignant pleural effusion. Methods A retrospective case series study was conducted. The clinical data of 101 patients with pleural effusion from October to December 2021 in Shanxi Bethune Hospital were retrospectively analyzed. Liquid-based cytology (LBC) and DNA-ICM were performed on pleural effusion specimens. The sensitivity and specificity of the two methods were compared with the clinical diagnosis, imaging, biopsy, and follow-up results of the patients. Results Among the pleural effusions of 101 patients, 39 were malignant pleural effusions and 62 were benign pleural effusions. The sensitivity of LBC and DNA-ICM in diagnosing malignant tumor cells in pleural effusions was 74.7% and 94.9%, respectively, and the specificity was 98.4% and 83.9%, respectively the combination of the two had an increased diagnostic positivity rate compared with that of LBC alone [36.6% (37/101) vs. 28.7% (29/101)]. Seven cases with positive DNA-ICM but negative LBC result were followed up, and 1 case was diagnosed as small cell lung cancer. Conclusions DNA-ICM can effectively improve the positive cytology detection rate of pleural effusion, and the combined detection of DNA-ICM and LBC can reduce the underdiagnosis rate of cytology, which is of great clinical value in the pathological diagnosis of malignant pleural effusion.
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