Sears R J, Duckworth C W, Decaestecker C, Bourgeois N, Ledent T, Deviere J, Salmon I, Kiss R, Yeaton P
Digestive Health Center, University of Virginia Health Sciences Center, Charlottesville 22906-0013, USA.
Cancer. 1998 Apr 25;84(2):119-26. doi: 10.1002/(sici)1097-0142(19980425)84:2<119::aid-cncr9>3.0.co;2-k.
Routine brush cytology is relatively insensitive for the diagnosis of biliary and pancreatic malignancy. Sensitivity can be improved by measuring DNA and proliferation. The goal of this study was to assess the discriminatory capacity of image cytometry using pancreaticobiliary brush cytology specimens obtained during endoscopic retrograde cholangiopancreatography (ERCP). Analysis included morphometry, DNA quantification, and characterization of nuclear chromatin distribution and condensation.
Brush cytology specimens were obtained during ERCP from 22 chronic pancreatitis specimens, 11 pancreatic adenocarcinoma specimens, 13 primary sclerosing cholangitis specimens, and 11 cholangiocarcinoma specimens and contrasted with 25 normal epithelia specimens. A SAMBA 2005 image processor was used to analyze Feulgen stained chromatin density and distribution. Discriminant analysis of 37 morphonuclear variables was performed to characterize differences between: 1) chronic pancreatitis and pancreatic adenocarcinoma, and 2) primary sclerosing cholangitis and cholangiocarcinoma.
Chronic pancreatitis was distinguished from pancreatic adenocarcinoma (P < or = 0.001); sensitivity and specificity were both estimated to be 82%. Primary sclerosing cholangitis was distinguished from cholangiocarcinoma (P < or = 0.01); sensitivity and specificity were estimated to be 82% and 85%, respectively.
Multiparameter image cytometry has potential as an adjuvant diagnostic technique in patients with pancreaticobiliary malignancy.
常规刷片细胞学检查对胆管和胰腺恶性肿瘤的诊断相对不敏感。通过测量DNA和增殖情况可提高其敏感性。本研究的目的是评估利用内镜逆行胰胆管造影术（ERCP）获取的胰胆管刷片细胞学标本进行图像细胞术的鉴别能力。分析包括形态计量学、DNA定量以及核染色质分布和凝聚的特征描述。
在ERCP过程中从22份慢性胰腺炎标本、11份胰腺腺癌标本、13份原发性硬化性胆管炎标本和11份胆管癌标本中获取刷片细胞学标本，并与25份正常上皮标本进行对比。使用SAMBA 2005图像处理器分析福尔根染色的染色质密度和分布。对37个形态核变量进行判别分析，以描述以下两组之间的差异：1）慢性胰腺炎与胰腺腺癌，以及2）原发性硬化性胆管炎与胆管癌。
慢性胰腺炎与胰腺腺癌得以区分（P≤0.001）；敏感性和特异性估计均为82%。原发性硬化性胆管炎与胆管癌得以区分（P≤0.01）；敏感性和特异性估计分别为82%和85%。
多参数图像细胞术在胰胆管恶性肿瘤患者中具有作为辅助诊断技术的潜力。
