Weissman G S, McKinley M J, Budman D R, Caccese W J, Schulman P, Grueneberg D, Bronzo R L
Cornell University Medical College, New York.
J Clin Gastroenterol. 1987 Oct;9(5):599-602. doi: 10.1097/00004836-198710000-00025.
The diagnosis of peritoneal carcinomatosis is often dependent on the finding of malignant cells in ascitic fluid analysis by a trained cytologist. Other methods are needed to increase the current diagnostic yield of 60-90%. Abnormal DNA content is characteristic of most malignancies. In an attempt to detect aneuploidy, we used high-resolution DNA histogram analysis with fluorescent DNA-specific stains and flow cytometry to evaluate 33 ascitic fluid samples. Of 13 patients with malignant ascites, aneuploidy was demonstrated in 10. Six patients with proven peritoneal carcinomatosis and normal cytologic examination had abnormal DNA histograms. DNA quantitation and cytologic examination agreed in 24 of 33 cases. These findings suggest that flow cytometry is a rapid and useful technique in the diagnosis of malignant ascites. The presence of aneuploidy in cells from ascitic fluid is highly suspicious for peritoneal carcinomatosis and suggests the need for further evaluation for malignancy.
腹膜癌的诊断通常依赖于训练有素的细胞学家对腹水进行分析以发现恶性细胞。需要其他方法来提高目前60%至90%的诊断率。DNA含量异常是大多数恶性肿瘤的特征。为了检测非整倍体，我们使用高分辨率DNA直方图分析，结合荧光DNA特异性染色和流式细胞术来评估33份腹水样本。在13例恶性腹水患者中，10例显示有非整倍体。6例经证实有腹膜癌且细胞学检查正常的患者，其DNA直方图异常。33例中有24例DNA定量与细胞学检查结果一致。这些发现表明，流式细胞术是诊断恶性腹水的一种快速且有用的技术。腹水中细胞存在非整倍体高度怀疑为腹膜癌，提示需要进一步评估是否存在恶性肿瘤。
