Pimenova E L, Bogatyrev V N, Sheremet'eva G F, Got'e S V, Kamalov Iu R, Chistiakova O V, Ivanova A G
N. N. Blokhin Russian Cancer Research Centre, Moscow.
Arkh Patol. 2000 Jul-Aug;62(4):11-6.
Because of insufficient amount of material obtained in many cases of puncture biopsy, Differential diagnosis of hepatocellular carcinoma (HCC) with benign tumors and focal cirrhotic lesions of the liver is difficult. The study was aimed at development of additional criteria for HCC differential diagnosis of the basis of a comparison of morphological data (histological and cytological) with DNA content in the cells of focal lesion of the liver and is based on the research of biopsy material from 111 patients with focal liver lesions. Laser DNA flow cytometry (DNA-FCM) was carried out in 59 samples using laser flowing cytometer FACScan (Becton Dickinson, USA). The complex of three HCC histological criteria was established (trabecular histoarchitecture, increased nuclear-cytoplasmatic rate and nuclear crowding) for comparison with puncture biopsy of the liver (diagnostic efficiency 93.7%). Optimal quantitative parameters for HCC diagnosis were the following: reduction of the number of cells in a GO/1 phase of the cell cycle (< 77.5%), appearance of aneuploid clone of cell DNA index > 1.0 and decreased percent of binucleated cells (< 10%). Very high diagnostic specificity of the research was found (98.3%). Usage of quantitative parameters in the complex with histological criteria of HCC increased efficiency of the diagnosis up to 98%.
由于在许多穿刺活检病例中获取的材料数量不足，肝细胞癌（HCC）与肝脏良性肿瘤和局灶性肝硬化病变的鉴别诊断存在困难。该研究旨在基于肝脏局灶性病变细胞形态学数据（组织学和细胞学）与DNA含量的比较，制定HCC鉴别诊断的附加标准，研究基于对111例肝脏局灶性病变患者的活检材料进行研究。使用激光流式细胞仪FACScan（美国贝克曼库尔特公司）对59个样本进行了激光DNA流式细胞术（DNA-FCM）检测。建立了三个HCC组织学标准的复合体（小梁状组织结构、核质比增加和核拥挤），用于与肝脏穿刺活检进行比较（诊断效率为93.7%）。HCC诊断的最佳定量参数如下：细胞周期G0/1期细胞数量减少（<77.5%）、出现DNA指数>1.0的非整倍体细胞克隆以及双核细胞百分比降低（<10%）。研究发现该检测具有非常高的诊断特异性（98.3%）。将定量参数与HCC组织学标准结合使用可将诊断效率提高至98%。
