甲状腺肿瘤细胞核DNA含量测定对病理诊断的意义

应用真彩色医学图像分析技术， 对９０ 例甲状腺肿瘤（其中甲状腺腺瘤１０ 例， 不典型腺瘤１５ 例，乳头状腺癌２５ 例， 滤泡癌１５ 例， 髓样癌１５ 例， 未分化癌１０ 例） 细胞核ＤＮＡ含量进行了分析。结果显示，甲状腺腺瘤组与各型甲状腺癌比较均有显著性差异（Ｐ＜ ００１），甲状腺腺瘤组同不典型腺瘤组比较无统计学意义（Ｐ＞ ００５）。甲状腺癌随组织分化程度的不同， ＤＮＡ 含量明显增加， 多为高倍异倍体细胞， ＤＮＡ直方图明显右移， 峰值主要位于≥５Ｃ处； 甲状腺腺瘤组ＤＮＡ含量较低， 多为低倍整倍体细胞， ＤＮＡ 直方图峰值位于２Ｃ－ ４Ｃ处； 不典型腺瘤组ＤＮＡ含量介于上述二者之间， ＤＮＡ 直方图逐渐右移。表明ＤＮＡ倍性程度与肿瘤的增殖程度呈正相关， 高倍异倍体细胞随肿瘤恶性程度的增高而增多。作者认为ＤＮＡ原位图像定量分析可为甲状腺肿瘤的诊断、分级及早期发现癌变趋势提供一个可靠的参考指标

THE PATHOLOGIC SIGNIFICANCE OF CELL NUCLEUS DNA CONTENTS IN THE DIAGNOSIS OF THYROID NEOPLASMS

The cell nucleus DNA contents of thyroid tumors from 90 cases (including 10 thyroid adenoma, 15 atypical adenoma, 25 papillary adenocarcinoma, 15 folicular carcinoma, 15 medullary carcinoma and 10 undifferentiated carcinoma) were measured quantitatively using real color image analysis technique. The results showed that there was significant difference in DNA content between thyroid adenoma and thyroid carcinoma(P<0 01),and no difference between thyroid adenoma and atypical adenoma(P>0 05). The DNA contents of the thyroid carcinoma were increased remarkably with the degree of histological differentiation and most of them were polyploid and aneuploid cells. The DNA histogram shifted obviously toward right and the peak located at 5C. The DNA contents of the thyroid adenoma were lower, most of the cells were low ploid, the peak of the DNA histogram was at 2C-4C. The DNA content of the atypical adenoma was between that of thyroid adenoma and thyroid carcinoma and the DNA histogram gradually shifted to right. The results above indicated that the DNA ploidy was related to the tumor's proliferation; the more malignant was the tumor, the more polyploid and aneuploid were the cells. In our opinion the situ image quantitative analysis of DNA may be a valuable method in the diagnosis, grading of thyroid neoplasma, as well as in the early finding of canceration tendency.