Evaluation of nuclear morphometry and DNA ploidy status for detection of malignant and premalignant oral lesions:: Quantitative cytologic assessment and review of methods for cytomorphometric measurements
Evaluation of nuclear morphometry and DNA ploidy status for detection of malignant and premalignant oral lesions:: Quantitative cytologic assessment and review of methods for cytomorphometric measurements
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DOI：
10.1016/j.joms.2005.12.010
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发表时间：
2006-04-01
影响因子：
1.9
通讯作者：
Karslioglu, Y
中科院分区：
文献类型：
--
作者：
Pektas, ZÖ;Keskin, A;Karslioglu, Y
目的：检测出较小的癌前病变或癌性病变是提高口腔癌 5 年生存率的最重要因素之一。尽管手术活检是诊断口腔病变最明确的方法，但常规对大量患者进行活检是不切实际的。最近，通过先进的计算机辅助图像分析系统改进的细胞形态测量评估变得越来越重要。本研究旨在评估核细胞形态分析和 DNA 倍性状态检测口腔恶性肿瘤的功效。还回顾了用于细胞形态计量分析的方法。 患者和方法：在活检前立即使用细胞刷从出现各种口腔病变的患者 (n = 22) 中获取口腔粘膜涂片 (n = 44)。 Feulgen 染色程序后进行细胞形态测量和核 Feulgen DNA 含量分析。来自病变部位的涂片构成研究组，而对侧健康粘膜部位作为对照。结果：DNA 倍性分析显示，从舌侧缘和口底采样的 20 个二倍体 (90.9%) 和 2 个非整倍体 DNA 模式 (9.1%)。当仅考虑恶性病变时，非整倍体率为 16.7%，而二倍体模式为 83.3% 的样本。通过细胞形态测量，核周长、面积、相当于圆的直径、最小和最大费雷特、强度、DNA 含量 (c) 和 DNA 指数值显示出统计学上的显着差异。结论：通过口腔刷活检进行细胞形态测量分析是活检的一个有价值的辅助手段，用于识别癌前和早期癌性口腔病变，作为一种快速、微创的手术，具有高特异性和敏感性，无需局部麻醉。 (c) 2006 年美国口腔颌面外科医师协会 J Oral Maxillofac Surg 64：628-635，2006 年。
Purpose: Detection of a precancerous or cancerous lesion when small is one of the most important factors to improve 5-year survival rates of oral cancer. Although surgical biopsy is the most definitive method for diagnosing oral lesions, it is impractical to routinely subject large numbers of patients to biopsy. Recently, cytomorphometric assessments improved by advanced computer-assisted image analysis systems have gained importance. This study was established to evaluate the efficacy of nuclear cytomorphometric analysis and DNA ploidy status for the detection of oral malignancies. Methods used for cytomorphometric analysis were also reviewed.Patients and Methods: Oral mucosal smears (n = 44) were obtained from patients (n = 22) presenting with various oral lesions using a cytobrush immediately before biopsy. Cytomorphometric measurements and nuclear Feulgen DNA content analysis were carried out after the Feulgen staining procedure. Smears from the lesion site constituted the study group whereas contralateral healthy mucosal sites served as control.Results: DNA ploidy analysis revealed 20 diploid (90.9%) and 2 aneuploid DNA patterns (9.1%) sampled from the lateral margin of the tongue and floor of the mouth. When only malignant lesions were considered, aneuploidy rate was 16.7% whereas a diploid pattern was indicated for 83.3% of the sample. With cytomorphometric measurements, a statistically significant difference was shown for nuclear perimeter, area, diameter equivalent to circle, minimum and maximum Feret, intensity, DNA content (c) and DNA index values.Conclusions: Cytomorphometric analysis via oral brush biopsy is a valuable adjunct to biopsy for identification of premalignant and early stage cancerous oral lesions as a rapid and minimally invasive procedure with high specificity and sensitivity rates, requiring no topical or local anesthetic. (c) 2006 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 64:628-635, 2006.