摘要
目的 探讨肺癌细胞核的有关体视学参数在肺癌诊断分型方面的意义.方法 收集肺癌外科手术切除标本70例及肺癌患者自身正常组织8例,分为鳞癌组（a）、腺癌组（b）、腺鳞癌组（c）、小细胞癌组（d）、大细胞癌组（e）及正常组（f）6组.每例随机切3个蜡块,HE染色,每张切片随机取3～4个视野,用Image-Pro图像分析软件对细胞核及细胞进行测试,按体视学公式计算以细胞为参照空间时细胞核的下列8项参数：体积密度（Vvn）、表面积密度（Svn）、表面积与体积比（Rsvn）、数密度（Nvn）、核浆比（Rnp）、平均体积（vn）、平均表面积（sn）及平均自由程（λn）.用SPSS11.5行方差分析和组间两两比较,并行逐步判别分析.结果 Vvn、Svn、Nvn、vn、sn、λn、Rsvn及Rnp 8项参数在肺鳞癌、肺腺癌、肺腺鳞癌、肺大细胞癌、肺小细胞癌及正常对照组6组之间的方差分析中均有显著性差异.由Vvn、Svn、Nvn、vn、sn、λn、Rsvn及Rnp8项参数所建立的肺癌组与正常组的判别函数,肺癌组70例及正常组8例判别均正确;由Vvn、Svn、Rsvn、vn、sn及λn六项参数所建立的不同类型肺癌及正常组的判别函数和由Vvn、Svn、sn及λn四项参数所建立的不同类型肺癌的判别函数,肺鳞癌和肺腺癌的准确度均为90%,判别6例肺小细胞癌均正确.结论 1.在肺癌的判别方面,Vvn、Svn、Rsvn、Nvn、Rnp及λn6项参数对肺小细胞癌均是有判别能力的参数;Vvn、Nvn、vn、sn及Rsvn 5项参数对肺鳞癌、肺腺癌、肺腺鳞癌及肺大细胞癌4组非小细胞肺癌均是有判别能力的参数;Rnp对肺鳞癌和肺腺癌是有判别能力的参数;2.在肺癌分型方面,Vvn、Svn、Nvn、λn及Vn均可做为区分肺小细胞癌与非小细胞肺癌的有意义参数;但仅依据肺癌细胞核的有关体视学参数很难对非小细胞肺癌组织学亚型进行满意分类;3.用Vvn、Svn、Nvn、vn、sn、λn、Rsvn及Rnp 8项参�
Objective To discuss the value of the nuclear stereologic parameters on the diagnosis and type about the lung carcinomas. Methods The seventy lung carcinomatous specimens and eight normal lung mucosas were obtained from the lung surgical resections, which were grouped into squamous cell carcinomas （a） , adenocarcinomas （b） , adenosquamous carcinomas （c） , small cell carcinomas （d） , larger cell carcinomas （e） and normal group （f）. Three or four views were selected stochastically from each stain cut from three paraffin masses selected randomly and stained by Hematoxylin-Eosin. We measured the nucleus and reference space using the Image-Pro analytical software. Using the carcinomatous cells as the reference space, the following parameters were acquired according to the stereologic formulas. The parameters consisted of the nuclear volume density （Vvn） , surface density （Svn） , the surface/volume ratio （ Ravn）, numerical density （ N ）, the nuclear/cytoplasmic ratio （ Rnp）, mean nuclear volume （ vn ）, mean nuclear surface （sn）, mean free distance of components （λn）. The parameters were compared to analysis the differences among different groups and submitted to stepwise discriminant analysis. Result There were significant differences among the above eight parameters in the six groups. The seventy lung carcinomatous specimens and eight normal lung mucosas were discriminated accurately by the first discriminant equations. The dicriminant accuracy of the lung squamous cell carcinomas and adenocarcinomas was 90 percent and the six small cell lung carcinomatous specimens were all discriminated correctly using the second or third discriminant equations. Conclusion First, the parameters of Vvn , Svn, Nvn, Rsvn, Rnp and λn can be used to discriminate between the small cell lung carcinomas and the normal lung mucosas. And the parameters of V , N,, R v and s, can be used to discriminate between the non-small cell lung carcinomas and the normal lung mucosas. In addition,
出处
《中国体视学与图像分析》
2006年第3期177-182,共6页
Chinese Journal of Stereology and Image Analysis
基金
国家自然科学基金项目30271462
广东省科技攻关项目2KM04501S
广州市科技攻关重点项目(2003Z2-E0061
E0062)
关键词
肺癌
体视学
定量
诊断
lung carcinoma
stereology
diagnosis
