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目的:用DNA倍体分析法判断口腔黏膜病病变的严重程度。方法:用小刷刷取口腔黏膜病变处的上皮细胞,直接涂片制成1-2张玻片,经Feulgen染色,用全自动DNA图像分析仪测定细胞核内DNA含量。部分患者在可疑处活检做组织病理检查,将活检病例分成DNA倍体分析组和阴性组,比较两组病例病变的严重程度。结果:303例口腔黏膜病例中有口腔溃疡237例、口腔扁平苔藓17例、红斑34例、白斑25例。经DNA倍体分析其中267例为阴性,36例为阳性。将经活检组织病理检查97例患者分成DNA倍体分析阳性组和阴性组。在36例DNA倍体分析阳性病例中有11例组织像正常或炎性病变、6例轻度异常增生、9例中度异常增生、6例重度异常增生和4例浸润癌,中度异常增生以上改变19例,其阳性率为52.78%;61例DNA倍体分析阴性病例中发现有52例组织像正常或炎性病变、6例轻度异常增生、3例中度异常增生和1例浸润癌,中度异常增生以上改变3例,其阳性率为4.91%。经方差分析,两组之间有显著性差别(x2=30.98,P<0.005)。结论:测定口腔黏膜病变处细胞DNA含量是一种无创伤且能判别出病变严重程度的方法。
Objective: To determine the severity of oral mucosal lesions by DNA ploidy analysis. Methods: The epithelial cells of oral mucosal lesions were swabbed with a small brush and directly slides were made into 1-2 glass slides and stained with Feulgen. The content of DNA in the nucleus was measured by automatic DNA image analyzer. Some patients were biopsied at a suspicious place for histopathological examination. The biopsy cases were divided into DNA ploidy analysis group and negative group, and the severity of the disease was compared between the two groups. Results: Of the 303 cases of oral mucosa, there were 237 cases of oral ulcer, 17 cases of oral lichen planus, 34 cases of erythema and 25 cases of white spot. 267 cases were negative by DNA ploidy analysis and 36 cases were positive. 97 cases of biopsy histopathological examination were divided into DNA ploidy analysis positive group and negative group. Of the 36 DNA ploidy positive cases, 11 showed normal or inflammatory lesions, 6 had mild dysplasia, 9 had moderate dysplasia, 6 had severe dysplasia, and 4 had invasive cancer with moderately abnormal proliferation The above changes were made in 19 cases and the positive rate was 52.78%. In the 61 negative cases of DNA ploidy analysis, 52 cases were found as normal or inflammatory lesions, 6 cases with mild dysplasia, 3 cases with moderate dysplasia and 1 case with infiltration In 3 cases of cancer and moderate abnormal hyperplasia, the positive rate was 4.91%. By ANOVA, there was a significant difference between the two groups (x2 = 30.98, P <0.005). CONCLUSIONS: Determining the cellular DNA content of oral mucosal lesions is a noninvasive method that can determine the severity of the lesion.