细胞图象分析在判断卵巢上皮癌生物学行为及其患者预后中的价值

目的 :探讨细胞图像分析在判断卵巢上皮癌 (OEC)生物学行为及患者预后的价值。方法 :应用细胞图像分析技术 (ICM)测定 4 0份原发性卵巢上皮癌组织的细胞核DNA含量及核形态参数 ,同时以免疫组化LSAB法分析其p53、p16的表达情况。结果 :OEC病例中腹水阳性、腹腔广泛转移、淋巴转移、低分化各组的DNA指数 (DI)、超 5倍体( 5C)细胞比率、核面积 (NA)均明显增高 ,与对照组相比 ,差异有显著性 (P <0 .0 5) ,但在不同临床分期间差异无显著性 (P >0 .0 5)。ICM各项参数中超 5C细胞比率、NA与DI有明显相关性 (P均 <0 .0 1)。在OEC病例中p53阳性、p16阴性的DI、超 5C细胞比率、NA不仅明显高于对照组 (P <0 .0 5) ,而且与OEC患者的预后密切相关 (P <0 .0 1,P <0 .0 5)。结论 :较高的DI、超 5C细胞比率、NA提示OEC具有较高的恶性生物学行为及不良预后 ,且各指标与p53、p16的表达情况均明显相关 ,共同检测可作为诊断卵巢恶性肿瘤的有用指标 ,并有助于指导术后辅助性治疗方案的选择及预测患者预后

Discussion on the value of image cytometry in determining the biological behaviour and prognoses of patients with ovarian epithelial cancer

Objective:To explore the value of image cytometry in determining the biological behaviour and prognosis of patients with ovarian epithelial cancer(OEC).Methods:DNA content and nuclear morphology parameter in 40 samples of primary ovarian epithelial cancer tissues were examined with image cytometry(ICM).The expressions of p53,p16 were detected with immunohistochemistry labelled strept Avidin-Biotincomplex(LSAB).Results: DNA index(DI),the percentage of cells exceeding 5C,nuclear area(NA)in OEC patients with ascites(+),abdominal cavity lymphnode metastasis,low differenciated tumor were significantly increased when comparied with the control group(P＜0.05).There was no obvious difference in various clinical stage(P＞0.05)。There was obviouslycorrelation in the percentage of cells exceeding 5C,NA and DI(P＜0.01).In OEC cases,DI,the percentage of cells exceeding 5C and NA with p53(+),p16(-)were not only significantly higher than those of the control group(P＜0.05),but also had close correlation with the patients' prognoses(P＜0.05) Conclusions:The higher the DI,the percentageof cells exceeding 5C and the NA,the higher the malignant behaviour with poor prognoses are OEC patients.The three indexes have obvious correlation with theexpressions of p53,p16. Detect these indexes may be useful as accessory diagnosisto the ovarian malignant tumor.It is also helpful to guide accessory treatment after operation and predict prognoses of patients with OEC.