角结膜缘上皮良、恶性病变细胞核DNA原位图像定量分析

应用真彩色医学图像分析技术,对５１例角结膜缘上皮良、恶性病变（其中上皮增生１９例,不典型增生６例,原位癌１４例,鳞状细胞癌１２例）进行了ＤＮＡ原位定量分析研究．结果显示：原位癌和鳞状细胞癌ＤＮＡ含量明显增加,多为高倍异倍体细胞,ＤＮＡ直方圆明显右移,峰值主要位于＞５Ｃ处,≥５Ｃ细胞分别占７８．８９％和７８．３１％;上度增生病变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,２Ｃ～４Ｃ细胞占８８．５９％;上皮不典型增生病变ＤＮＡ含量介于良性病变和癌之间,ＤＮＡ直方图逐渐右移,２Ｃ～４Ｃ细胞占５８．６２％,≥５Ｃ细胞占４１．３８％。以上数据经统计学处理各组间有显著性差异。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角结膜缘上皮良、恶性病变的诊断、分级及早期发现癌变趋势提供一个可靠的参考指标。     

口腔肿瘤的预后与肿瘤细胞异倍体关系

目的研究口腔肿瘤预后与异倍体细胞的关系。方法口腔肿瘤切除后,将肿瘤组织在玻片印1-2张。经Feulgen染色,用DNA图像分析系统分析DNA含量。将DNA倍体分析异常结果分为3级,Ⅰ级为少数5c异倍体细胞,Ⅱ级可见1个异倍体细胞峰,Ⅲ级可见多个异倍体细胞峰。其余肿瘤组织做病理分型分期。结果 30例口腔肿瘤按转移情况分为Ⅰ级19例,Ⅱ级6例和Ⅲ级5例。在19例Ⅰ级病例中,有12例(12/19)DNA倍体分析发现有5c异倍体细胞峰。30例口腔肿瘤按病理分化程度分为16例高分化,9例中等分化和5例低分化程度。在16例高分化病例中,有11例(11/16)可见5c异倍体细胞而无异倍体细胞峰。14例中等或低分化病例中,有12例可见DNA异倍体细胞峰。结论口腔肿瘤细胞异倍体细胞数量及细胞峰型与肿瘤分期和分化程度有关,即异倍体细胞越多,预后越差。     

胃癌细胞DNA含量、AgNOR计数与其生物学特性关系的研究

本文使用图像分析技术测定了正常胃粘膜、萎缩性胃炎、不典型增生及胃癌共８９例细胞ＤＮＡ相对含量及ＤＮＡ倍体分布;并用银染方法对８９例细胞核仁形成区嗜银蛋白进行定量分析。结果显示：不典型增生往往可观察到与胃癌相似的ＤＮＡ核型即高异倍体的出现,高异倍体的出现可能是重要的癌前标志;在胃粘膜病变中,ＡｇＮＯＲ值随病变异型程度的加重而递增,各组间差异均有非常显著性意义（Ｐ＜０．０１）。早期癌、浸润癌和转移癌间,以及癌转移过程中粘膜层、肌层、淋巴结内癌细胞ＤＮＡ含量无明显差异;ＡｇＮＯＲｓ计数均值差异亦无非常显著性意义（Ｐ＞０．０５）。随癌细胞分化程度升高,ＤＮＡ含量增多及异倍体出现率升高;各期胃癌除粘激腺癌与分化型腺癌差异无显著性意义外,余各型胃癌ＡｇＮＯＲｓ值随分化程度升高而增多,差异有显著性意义（Ｐ＜０．０５或Ｐ＜０．０１）。因此,ＤＮＡ含量及倍体分析,ＡｇＮＯＲｓ计数与胃癌的生物学行为密切相关,可作为胃癌早期诊断,癌前病变预测以及组织分级的一种重要指标。     

不同分化程度的胃癌组织中DNA倍体和Ki67的变化

目的研究胃癌组织内DNA倍体细胞与Ki67的分布及相互关系。方法 59例胃癌病例行外科手术切除,将切除肿瘤组织印在玻片上,用Feulgen染色后测定细胞DNA含量,凡发现5c异常倍体细胞或细胞峰均为细胞学阳性。肿瘤组织做病理诊断和Ki67免疫组织化学染色。结果 59例胃肠病例中有47例低度分化,10例中度分化和2例高度分化。DNA倍体分析发现31例低分化和5例中等分化病例中可见30个异倍体细胞;15例低分化、4例中等分化和1例高分化病例可见10~30个异倍体细胞。三种分化程度各有1例10个异倍体细胞。Ki67免疫组织化学染色分析表明,24例低分化、6例中等分化和1例高分化病例中可见20%胃上皮细胞Ki67阳性;15个低分化和2个中等分化病例中发现Ki67阳性细胞占胃上皮细胞的10%~20%;8例低分化、2例中等分化和1例高度分化病例发现Ki67阳性细胞数占胃上皮细胞的10%以下。47例低分化胃上皮Ki67百分比与5c异倍体细胞数量正相关。结论胃癌组织中DNA异倍体细胞数与Ki67蛋白表达呈正相关,即DNA异倍体细胞愈多或Ki67表达愈多,胃癌恶性程度愈高。     

人体肝癌及其相关慢性肝病的肝细胞DNA含量定量分析

利用图像分析技术对轻度慢性活动性肝炎（ＭＣＡＨ）、重度慢性活动性肝炎（ＳＣＡＨ）、小结节肝硬变（ＭＩＮＣ）、大结节肝硬变（ＭＡＮＣ）、癌周肝硬变（ＰＣ）和肝细胞癌（ＨＣＣ）及正常对照共６７例样本的肝细胞或癌细胞ＤＮＡ含量进行测定分析。结果（１）ＭＣＡＨ、ＳＣＡＨ和ＭＡＮＣ多倍体化受抑制,显示细胞分化能力下降,可能与肝癌的发生相关;（２）ＨＣＣ均为异倍体肿瘤,细胞具有较高的增殖能力并处于较低的分化状态;（３）ＰＣ倍体分布和双核细胞率介于其他非癌病变和ＨＣＣ之间,细胞分化受抑制且有向异倍体发展趋势,具有癌前病变性质;（４）ＭＩＮＣ明显多倍体化,为分化性的再生修复病变而与肝癌发生无关。因此肝细胞ＤＮＡ含量的定量分析对于了解肝细胞的增生状态,以及患者的预后评估有重要意义。     

大蒜油抗肿瘤作用的流式细胞光度术分析

用流式细胞光度术（ｆｌｏｗｅｙｔｏｍｅｔｒｙ,ＦＣＭ）+Ｓ０．２ｍｌ／日。吐温对照组ｌＰ吐温８００．２ｍｌ／日,以排除大蒜油制剂中溶剂（吐温８０）的影响。实验组ｌＰＧＯ１００ｍｇ／ｋｇ／．日。于连续４次注射后的６ｈ,２、３、５、１０天及１０次注射ＧＯ后７天取材,行ＦＣＭ样品制备。三、ＦＣＭ样品制备与测定中国中医研究院基础所腹水癌细胞用ＰＢＳ洗涤,７０％酒精固定,ＲＮａｓｅ消化细胞中的ＲＮＡ,ＰＩ染色。用腹腔内淋巴细胞作标准二倍体细胞。用４２０型荧光激活细胞分选仪（美国Ｂｅｃｔｏ－Ｄｉｃｋｓｏｎ公司产品）测单个肿瘤细胞的ＤＮＡ含量,用组方图显示肿瘤细胞ＤＮＡ倍体性质。图中第一个是ＤＮＡ二倍体（ＺＣ）峰,处于该峰的细胞为Ｇ;／Ｇ。期细胞,第二个峰为４ＣＤＮＡ峰,该处细胞为Ｇ。－Ｉ－－Ｍ期细胞,从２。到４。之间的细胞为Ｓ期细胞。大于４。ＤＮＡ峰细胞为高倍体细胞‘’：。根据不同峰值大小判定用药后肿瘤细胞倍体性质的变化。结果ＮＳ与吐温对照组肿瘤细胞都为非整倍体性,且呈多倍体性（图１,２）。连续４次给药后６ｈ,绝大部分多倍体肿瘤细胞被杀伤,残存肿瘤细胞以二倍体为主,多倍体肿瘤细胞峰值显著下降,甚至在组方图上几乎显不出多倍     

表皮生长因子及受体在甲状腺肿瘤中的表达

目的:研究表皮生长因子(Epidermal Growth Factor,EGF)及受体(Epidermal Growth Factor Receptor,EGFR)及在甲状腺肿瘤中的表达。方法:应用免疫组织化学法检测91例甲状腺病变组织中EGFR和EGF的表达情况。结果:结节性甲状腺肿、甲状腺腺瘤、分化型甲状腺癌标本中EGFR表达的阳性率分别为15%、25%、68.62%,EGF表达的阳性率分别为10%、15%、68.62%,其中EGFR、EGF在分化型甲状腺癌与其余两组间差异均有统计学意义(P<0.05)。EGFR和EGF在甲状腺乳头状癌中的表达与性别、年龄、肿瘤大小、淋巴结转移、临床分期等临床因素无明显相关。结论:EGF和EGFR的表达可作为鉴别甲状腺肿瘤良恶性的一个指标。     

脂多糖对离体培养大鼠血管平滑肌细胞增殖的影响

本研究观察到１０－７～１０－５ｋｇ／Ｌ脂多糖（ｌｉｐｏｐｏｌｙｓａｃｈａｒｉｄｅ,ＬＰＳ）可显著促进血管平滑肌细胞（ＶＳＭＣ）的增殖及ＤＮＡ的合成（Ｐ＜００５）。５×１０－４～１０－３ｋｇ／ＬＬＰＳ却抑制ＶＳＭＣ的增殖及ＤＮＡ的合成,降低其活力（Ｐ＜００１）,并呈时间依赖效应。一氧化氮合酶抑制剂ＮＮｉｔｒｏＬＡｒｇｉｎｉｎｅ（ＬＮＮＡ）可拮抗ＬＰＳ的抑制作用。大剂量ＬＰＳ作用组ＶＳＭＣ上清液中一氧化氮（ＮＯ）代谢产物ＮＯ－３和ＮＯ－２的含量与对照组相比显著增加（Ｐ＜００１）,４８ｈ组比２４ｈ组增加９１％,７２ｈ组比４８ｈ组增加４５％;同时,诱导性一氧化氮合酶（ｉｎｄｕｃｔｉｖｅｎｉｔｒｉｃｏｘｉｄｅｓｙｎｔｈａｓｅ,ｉＮＯＳ）免疫组化染色呈阳性。结果表明,低浓度ＬＰＳ促进ＶＳＭＣ增殖和ＤＮＡ合成,而高浓度ＬＰＳ却明显抑制ＶＳＭＣ增殖和ＤＮＡ合成,降低其活力。这种抑制作用可能与ＬＰＳ诱导ＶＳＭＣ产生的ＮＯ有关。     

CD44V6和MMP-2在甲状腺肿瘤中的表达及其临床意义

目的:研究黏附分子CD44V6和基质金属蛋白酶-2(MMP-2)在甲状腺癌中的表达、相互关系及其与甲状腺癌侵袭转移的相关性.方法:采用SP免疫组化法检测114例甲状腺肿瘤组织中CD44V6和MMP-2的表达.结果:CD44V6和MMP-2在35例甲状腺乳头状癌(Papillary Thyroid Carcinoma,PTC)中阳性表达率分别为70.6%和73.5%,在41例甲状腺滤泡癌(Follicular Thyroid Carcinomas,FTC)中阳性表达率分别为70.7%和75.6%,均高于甲状腺腺瘤和结节性甲状腺肿组织中的表达,差异具有统计学意义(P＜0.05).在甲状腺癌组织中MMP-2和CD44V6的表达具有显著相关性(r=0.4828,P＜0.001).且两者表达与甲状腺癌的临床分期及有、无淋巴结转移显著相关.结论:CD44V6和MMP-2的表达与甲状腺癌分化程度、浸润和转移关系密切.CD44V6和MMP-2检测对甲状腺癌的诊断、分化程度、转移趋势和预后评估具有重要参考价值,是甲状腺癌侵袭、转移和预后判断的分子标志物.     

甲状腺肿瘤组织VEGF-C和ERβ的表达与LVD的相关性分析

目的:探讨甲状腺肿瘤和癌旁正常甲状腺组织中VEGF-C和ERβ的表达与组织平均淋巴管密度的相关性.方法:采用SP免疫组织化学染色检测116例甲状腺癌、56例甲状腺腺瘤和20例正常甲状腺组织中VEGF-C和ERβ及D2-40的表达;以D2-40阳性结果计算组织平均淋巴管密度(LVD).观察不同甲状腺组织中VEGF-C和ERβ的表达水平并分析其与LVD的相关性.结果:甲状腺癌组织中VEGF-C的高表达阳性率显著高于正常甲状腺和甲状腺腺瘤(P＜0.05),ERβ的高表达阳性率显著低于正常甲状腺和甲状腺腺瘤(P＜0.05);两者表达呈轻度负相关(r=-0.312,P＜0.01);甲状腺癌VEGF-C表达与淋巴结转移和TNM分期有关(P＜0.01).用D2-40标记的LVD值在甲状腺癌、甲状腺腺瘤和正常甲状腺组织之间有显著性差异(P＜0.001).甲状腺癌中淋巴结转移组LVD显著高于无淋巴结转移组(P＜0.0001).VEGF-C表达与D2-40呈正相关(r=0.515,P＜0.01).结论:ERβ表达下调可能通过促进VEGF-C的表达,进而影响淋巴管增生,促进肿瘤淋巴道转移.     

DNA cytometry in pleomorphic adenomas with cytologic atypia

OBJECTIVE: To investigate the nuclear DNA content of pleomorphic adenomas with cytologic atypia. STUDY DESIGN: Analysis was performed on new, fuchsin-stained samples of 10 selected cases of pleomorphic adenoma with cytologic atypia. Morphometric analysis was done by a computer-assisted image cytometry system and consisted of the determination of DNA indices, Auer DNA histogram types, and 3c and 5c exceeding rates. RESULTS: Eight cases were diploid and two cases aneuploid according to the DNA index. The Auer histogram was type I in five cases and type III in the others. In the two aneuploid cases the 3c exceeding rate was > 10% and the 5c exceeding rate > 1%. CONCLUSION: Atypical cells in pleomorphic adenomas with cytologic atypia carry abnormal amounts of DNA. Image cytometry can make detecting very low numbers of aneuploid cells easier due to its higher resolution as compared to that of flow cytometry.     

DNA content of Hurthle cell nodules in autoimmune thyroiditis

Hurthle cells are found in thyroid neoplasms and in reactive nodules in thyroiditis or goitrogenic processes. Cytometric studies have evaluated Hurthle cell neoplasms but not their reactive counterparts. DNA content of Hurthle cells in 22 cases of autoimmune thyroiditis was measured by flow cytometry and image content of Hurthle cells in 22 cases of autoimmune thyroiditis was measured by flow cytometry and image processing using nuclei extracted from paraffin-embedded tissue after microdissection of the Hurthle cell nodules. All 22 autoimmune thyroiditis Hurthle cell nodules were diploid, including 16 without associated neoplasms and six with associated malignant neoplasms (four papillary carcinomas, one follicular carcinoma and one follicular adenoma with papillary carcinoma). Concordance between flow cytometry and image processing was 100%. These findings indicate that the markedly atypical Hurthle cells in autoimmune thyroiditis are diploid by DNA quantitation. This suggests that atypia in Hurthle cells due to reactive or neoplastic processes may be differentiated by quantitative DNA analysis.     

Correlation between automated DNA ploidy measurements of Hürthle-cell tumors and their histopathologic and clinical features

The treatment of Hürthle-cell tumors of the thyroid is controversial because of their rarity and the inconsistent histopathologic criteria for their diagnosis. In order to obtain more objective criteria for the management of Hürthle-cell tumors, the nuclear DNA content of cells from 20 cases was measured with the MicroTICAS system and the correlation between the DNA distribution patterns and the clinical and histopathologic findings was evaluated. Three main DNA patterns were found: euploid, polyploid and aneuploid. The euploid or polyploid Hürthle-cell tumors came from patients who did not develop distant metastases or recurrence whereas the aneuploid variants came from patients who died of their disease and/or developed distant metastases and recurrence. Various correlation analyses were performed between DNA ploidy and age, sex, size of tumor, growth pattern, pleomorphism, invasion and metastases. Our data suggests that an aneuploid DNA pattern or one with a large percentage of aneuploid nuclei with DNA content exceeding 5N may predict eventual metastases or recurrence from Hürthle-cell tumor.     

The resolution of aneuploid DNA stem lines by flow cytometry: limitations imposed by the coefficient of variation and the percentage of aneuploid nuclei

Factors important in the resolution of cell sub-populations with differing DNA contents were investigated using an EPICS C flow cytometer. Software is available for the EPICS C which permits data from any two histograms to be superimposed or added together before display. Samples of fresh and archival thyroid tissue, stained with propidium iodide, were analysed on the flow cytometer and the peak channel number noted. The photomultiplier (PMT) voltage was increased and the sample analysed again producing a second histogram with a higher peak channel number. The two histograms were added together to simulate a cell suspension with two sub-populations with a different DNA content. By systematically altering the PMT voltage and the number of nuclei included in each analysis, it was possible to examine the importance of DNA index and the percentage of tumor cells with an aneuploid DNA content for both fresh and paraffin-embedded thyroid nuclei. The crucial importance of achieving a low coefficient of variation (CV) was demonstrated and consequently the reservations that pertain when archival material is studied, particularly in tumours where DNA aneuploidy is frequently expressed with a low DNA index.     

DNA ploidy and markovian analysis of neoplastic progression in experimental pancreatic cancer.

Computer-assisted analysis of DNA ploidy and nuclear morphology were used to elucidate changes in the cell nucleus that occur during the development of experimental pancreatic cancer. Ductal pancreatic adenocarcinoma was induced in 49 Syrian hamsters by SC injection of N-nitrosobis (2-oxopropyl) amine; twenty hamsters served as controls. Groups of animals were sacrificed every 4 weeks for 20 weeks and adjacent sections of pancreatic tissue were H&E and Feulgen-stained for light microscopy and computer assisted cytometry. Pancreatic ductal cells were classified as normal, atypical, or malignant; tissue inflammation (pancreatitis) was also noted when present. DNA ploidy and nuclear morphology evaluation (Markovian analysis) identified an atypical cell stage clearly distinguishable from either normal or malignant cells; pancreatitis preceded this atypia. The DNA ploidy histogram of these atypical cells revealed a major diploid peak and a minor aneuploid peak. The receiver operator characteristic curve areas for a logistic regression model of normal vs atypical cells was 0.94 and for atypical vs malignant was 0.98, numbers indicative of near-perfect discrimination among these three cell types. The ability to identify an atypical cell population should be useful in establishing the role of these cells in the progression of human pancreatic adenocarcinoma.     

AgNOR染色对甲状腺良、恶性病变诊断价值的研究

本文应用ＡｇＮＯＲ染色技术对７３例甲状腺良恶性病变石蜡切片核仁组成区变化进行观察,其中包括亚急性甲状腺炎５例、腺瘤２５例、结节性甲状腺肿７例、甲状腺癌３６例,结果表明亚急性甲状腺炎、腺瘤、结节性甲状腺肿,细胞核内的ＡｇＮＯＲ颗粒均数及形态与甲状腺癌的均数及形态比较有显著性差异（Ｐ＜０．０１）。我们认为此方法对于区别甲状腺良、恶性病变有一定参考价值。     

Atypical Mesothelial Cells Associated With Eosinophilic Pleural Effusions: Nuclear Dna Content and Immunocytochemical Staining Reaction With Epithelial Markers

The nuclear DNA contents of atypical mesothelial cells from five patients who had an eosinophilic pleural effusion (EPE) were studied by the use of DAPI (4′,6-diamidino-2-phenylindole dihydrochloride) DNA staining. Analysis of the nuclear DNA content revealed a polyploid pattern, with a major peak in the tetraploid region. Using an immunocytochemical technique, the atypical mesothelial cells showed a positive reaction for cytokeratin. In contrast carcinoembryonic antigen (CEA) was always negative in these cells. It is suggested that the atypical mesothelial cells with EPE had a higher rate of proliferation than did the normal mesothelial cells.     

Methodologic aspects of DNA assessment by means of image cytometry in tumors of the salivary glands. A comparison between the results obtained using sections and cytospin preparations from the same paraffin-embedded specimens

The image cytometric nuclear DNA assessments on paraffin-embedded tissue sections and on Cytospin preparations of disaggregated specimens from the same cases were compared in 98 salivary gland tumors, including 21 acinic cell carcinomas, 29 mucoepidermoid carcinomas, 21 adenocarcinomas and 27 adenoid cystic carcinomas. The histogram type (diploid, tetraploid or aneuploid) and the number of cells with DNA values greater than 2.5c (expressed in relative units) were considered as variables in the correlation. A high correlation between the results in different specimens was found in acinic cell carcinomas, mucoepidermoid carcinomas and adenocarcinomas; the histogram type and the number of cells with DNA values greater than 2.5c were essentially the same between specimen types in these three tumor entities. The cases of adenoid cystic carcinomas showed a considerably lower degree of correlation: in 8 of the 27 cases, the Cytospin preparations yielded diploid histograms, while the tissue sections yielded aneuploid histograms. The number of cells with DNA values greater than 2.5c was notably lower in the Cytospin preparations from adenoid cystic carcinoma; the reasons for this exceptional behavior of the cells of adenoid cystic carcinoma are discussed. These findings demonstrate that paraffin-embedded specimens of different tumor entities, even from the same organ, can be affected differently by disaggregation procedures. While retrospective studies on disaggregated paraffin-embedded specimens can yield reliable results, comparative assessments using both DNA analysis techniques, as in this study, should be performed before a large number of cases is evaluated.     

Ploidy levels in nonneoplastic and neoplastic thyroid cells

DNA levels in nonneoplastic and neoplastic human thyroid cells were studied by slide-cytophotometric and flow-cytophotometric techniques. Normal epithelial thyroid cells and cells from nonneoplastic thyroid disorders, i.e., toxic goiter, colloid goiter and chronic lymphocytic thyroiditis, had euploid (diploid, polyploid) DNA levels. The same was the case for benign tumors. Malignant tumors had either euploid DNA levels, indistinguishable from those in nonneoplastic and benign neoplastic cell populations, or aneuploid DNA levels. Taking into account the histopathologic diagnosis, clinical course and DNA level, the results indicate that DNA measurements in thyroid gland lesions are of limited diagnostic help but may contribute valuable prognostic information. To obtain representative and accurate DNA measurements, combined slide-cytophotometric and flow-cytophotometric techniques should be used.     

Dependence of DNA-histograms on the sampling techniques in fine needle aspirates of the breast.

48 fine needle aspiration biopsy (FNAB) samples from 25 breast cancer cases, originally used for cytodiagnosis were subjected to DNA cytometry. There were air dried smears stained with the MGG method, and samples stained with HE or PAP stain after 50% ethanol fixation and cytocentrifugation. Different sampling strategies were applied. Four methods were tested: method 1: cell groups measured, method 2: all cells measured, method 3: free cells measured, and method 4: atypical free cells measured. Method 4 showed most often DNA aneuploid histogram patterns, sampling method 1 had the highest number of DNA diploid histogram patterns. Diagnostic approaches may benefit from a sampling method detecting the hiding aneuploid cell population. Grading of neoplasm could potentially benefit from other approaches.