Spyratos F, Briffod M
Laboratoire de Biologie Tissulaire, Centre René Huguenin de Lutte Contre le Cancer, Saint-Cloud, France.
Mod Pathol. 1997 Jun;10(6):556-63.
The aim of this study was to achieve a better definition of the respective indications of flow cytometry (FCM) and image cytometry (ICM) in clinical practice by comparing their efficiency in a series of 104 primary breast carcinomas that were sampled by means of fine-needle cytopuncture and analyzed by both methods. The comparison involved the DNA content and the estimation of S-phase fraction (SPF). For this purpose, a manual rectangular model was used for ICM, and Modfit software was used for FCM. With respect to DNA ploidy, the concordance rate between the two methods was 87% (DNA diploid vs. DNA nondiploid) and 81% when subclasses of DNA ploidy were used (hypodiploid, diploid, hyperdiploid, tetraploid, or multiploid). True discordance was observed in 19 cases (18%). Eleven of these discordances were the result of an underestimation of multiploidy by FCM. In the 91 cases evaluable by ICM, the SPF median value was 3.5 for DNA-diploid tumors and 8 for DNA-nondiploid tumors. In the 67 cases evaluable by FCM, the SPF median value was 2.31 for DNA-diploid tumors and 5.25 for DNA-nondiploid tumors. The concordance between ICM and FCM in the 46 uniploid tumors was 0.90. Our results led us to obtain samples for the two techniques systematically, to perform FCM routinely because it is more rapid and adequate in a large number of cases, to confirm by ICM any DNA-diploid or DNA near-diploid peak revealed by FCM, and to use ICM when FCM is inadequate, i.e., in case of low cellularity (fewer than 5000 cells for analysis of the cell cycle), suspected tetraploidy, samples not exclusively composed of malignant cells, the identification of several morphologically different malignant populations, or populations with large coefficients of variation and high background.
本研究的目的是通过比较流式细胞术（FCM）和图像细胞术（ICM）在104例原发性乳腺癌中的效率，更好地界定它们在临床实践中的各自适应证。这些乳腺癌通过细针穿刺取样，并采用两种方法进行分析。比较内容包括DNA含量和S期分数（SPF）的估计。为此，ICM使用手动矩形模型，FCM使用Modfit软件。关于DNA倍性，两种方法之间的一致率为87%（DNA二倍体与DNA非二倍体），当使用DNA倍性子类（亚二倍体、二倍体、超二倍体、四倍体或多倍体）时，一致率为81%。在19例（18%）病例中观察到真正的不一致。其中11例不一致是由于FCM低估了多倍体。在ICM可评估的91例病例中，DNA二倍体肿瘤的SPF中值为3.5，DNA非二倍体肿瘤的SPF中值为8。在FCM可评估的67例病例中，DNA二倍体肿瘤的SPF中值为2.31，DNA非二倍体肿瘤的SPF中值为5.25。46例单倍体肿瘤中ICM和FCM之间的一致性为0.90。我们的结果使我们有必要系统地获取两种技术的样本，常规进行FCM检测，因为它在大量病例中更快速且合适，通过ICM确认FCM显示的任何DNA二倍体或接近DNA二倍体的峰，并且当FCM不适用时使用ICM，即细胞数量少（用于细胞周期分析的细胞少于5000个）、怀疑四倍体、样本并非完全由恶性细胞组成、识别几种形态学上不同的恶性群体或变异系数大且背景高的群体的情况。
