论文部分内容阅读
目的 探讨新的痰标本收集和保存方法用于肺癌的辅助诊断。方法 分别用常规法和改良Saccomanno法 (以下简称改良S法 ) ,对 12 5例经细胞或组织病理学确诊的肺癌患者的痰标本进行处理。部分标本尚进行了p5 3突变基因检测和流式细胞术测定p5 3和p2 1蛋白。结果 用改良S法获得的痰标本涂片示癌细胞形态完整 ,背景杂质少 ,更易辨认。 12 5例患者常规法涂片发现肺癌细胞阳性者3 5例 ,改良S法发现 69例 ,阳性率分别为 2 8%和 5 5 .2 % ,二者间有显著性差异 (P <0 .0 1)。常规法和改良S法检出的阳性患者中分别有 2 6例和 5 8例能明确病理类型 ,二者比较差异也有显著性 (P <0 .0 1)。改良S法阳性率与肺癌病理类型、TNM分期和肺癌类型有密切关系 (P均 <0 .0 5 )。改良S法处理的痰标本中 ,41例用PCR SSCP 银染法检测p5 3基因突变 ,阳性率 5 3 .7% ( 2 2 / 41) ;3 0例用流式细胞术测定p5 3和p2 1蛋白含量 ,阳性率分别为 40 % ( 12 / 3 0 )和 5 3 .5 % ( 16/ 3 0 )。结论 改良S法处理的痰标本能很好地保存肺癌细胞形态和成分 ,易于检出。标本也适于肺癌相关的基因及蛋白检测。
Objective To explore new methods for collecting and preserving sputum specimens for the diagnosis of lung cancer. Methods Conventional and modified Saccomanno methods (hereinafter referred to as modified S method) were used to treat sputum specimens of 125 lung cancer patients diagnosed with cytopathology or histopathology. Some specimens were tested for p53 mutations and flow cytometry for p53 and p21 proteins. Results The smears of sputum samples obtained by the modified S method showed that the cancer cells had complete morphology, less background impurities, and were more easily recognizable. Thirty-five patients with positive lung cancer cells were found in 25 patients with routine smears, and 69 patients were diagnosed with modified S method. The positive rates were 28% and 55.2% respectively. There was a significant difference between the two (P < .0). 0 1). There were 26 cases and 58 cases with positive pathological types in the positive patients detected by the conventional method and the improved S method, and the difference between the two methods was also significant (P < 0.01). The positive rate of modified S method was closely related to the pathological type of lung cancer, TNM stage and lung cancer type (P all < 0.05). Of the sputum specimens modified by the modified S method, 41 cases were detected for mutations in the p53 gene by PCR SSCP silver staining, the positive rate was 53.7% (2 2 / 41); 30 cases were determined by flow cytometry for p53 and p2. 1 Protein content, positive rates were 40% (12/30) and 53.5% (16/30), respectively. Conclusion The modified S method treated sputum samples can well preserve the morphology and composition of lung cancer cells, and it is easy to detect. Specimens are also suitable for the detection of lung cancer-related genes and proteins.