Yang Ke, Zhao Jiuzhou, Hu Yanping, Ren Pengfei, Wu Xinxin, Wang Dongqing, Chen Dongxu, Yu Juan, Zhang Jun, Wang Zhizhong, Sun Rui, Zhao Chengzhi, Liu Zhenzhen, Ma Jie, Guo Yongjun, Wei Bing
Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
Endoscopic Diagnosis and Treatment Center, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
Sci Rep. 2025 Aug 8;15(1):29085. doi: 10.1038/s41598-025-13743-4.
To address inherent limitations of standard diagnostic procedures for lung cancer, like long turn-around-time and the need for sufficient samples for analysis, we innovatively integrated traditional smear cytology (TSC) with quantitative polymerase chain reaction (qPCR) assays on micro cell samples (MCSs) for the diagnosis of lung cancer. All patients underwent TSC and qPCR assays targeting 11 genes based on different MCSs, including samples obtained by flushing needles used for endobronchial ultrasound biopsies and percutaneous aspiration biopsies of lung in 38 cases (G1) and 108 cases (G2), and lavage fluid samples obtained by bronchoalveolar lavage in 38 cases (G3). With clinical diagnosis and pathological biopsy as diagnostic gold standard, the diagnostic value of these MCSs were explored. In G1, G2 and G3, the diagnostic yield of MCSs-based TSC alone was 78.9%, 93.5% and 76.3%, respectively. Combination of TSC and genetic testing increased the diagnostic yield to 81.6%, 98.1% and 84.2% in G1, G2 and G3, respectively. In addition, the qPCR results of MCSs and paired tissue samples was all matched with a concordance rate of 100%, and the quantity of DNA extracted from our samples was significantly higher than that of tissue samples in G1 and G2. Notably, the TAT of our diagnostic method required only 24 h, which greatly improved the timeliness of diagnosis. Our study demonstrated that MCSs-based TSC combined with genetic testing could not only rapidly and reliably diagnose lung cancer, but also effectively detect gene targets, with potential for widespread application.
为解决肺癌标准诊断程序的固有局限性，如周转时间长和需要足够样本进行分析，我们创新性地将传统涂片细胞学（TSC）与基于微细胞样本（MCS）的定量聚合酶链反应（qPCR）检测相结合，用于肺癌诊断。所有患者均接受基于不同MCS的TSC和针对11个基因的qPCR检测，包括通过用于支气管内超声活检的冲洗针和经皮肺穿刺活检获得的样本，其中38例（G1组）和108例（G2组），以及通过支气管肺泡灌洗获得的灌洗液样本38例（G3组）。以临床诊断和病理活检作为诊断金标准，探讨这些MCS的诊断价值。在G1组、G2组和G3组中，仅基于MCS的TSC诊断率分别为78.9%、93.5%和76.3%。TSC与基因检测相结合后，G1组、G2组和G3组的诊断率分别提高到81.6%、98.1%和84.2%。此外，MCS与配对组织样本的qPCR结果完全匹配，一致率为100%，且我们样本中提取的DNA量在G1组和G2组中显著高于组织样本。值得注意的是，我们诊断方法的周转时间仅需24小时，大大提高了诊断的及时性。我们的研究表明，基于MCS的TSC与基因检测相结合不仅可以快速、可靠地诊断肺癌，还能有效检测基因靶点，具有广泛应用的潜力。
