CAJ | 학술논문

目的观察垂体腺瘤的细胞增殖以及凋亡特性.探讨肿瘤侵袭性的相关因素和早期诊断指标.方法对垂体瘤固定标本行Ki-67单克隆抗体染色,应用流式细胞仪对新鲜垂体瘤标本进行DNA倍体和细胞凋亡分析.结果固定标本48例,侵袭性腺瘤28例,Ki-67高表达率为13/28,非侵袭组高表达率为6/20,两者相比统计学差异明显(χ~2=5.486,P=0.019),高表达对侵袭性诊断的灵敏性为46.5%,阳性预测值为68.3%.新鲜垂体瘤标本33例,侵袭性腺瘤15例,非侵袭性18例,非侵袭组S期细胞比例为0.8%～12.2%,平均4.8%,侵袭组为3.9%～24.2%,平均13.0%,两者相比统计学差舁明显(t=3.745,P=0.001),高于13.0%侵袭性诊断的灵敏性为40%,阳性预测值为100%;凋亡细胞比例侵袭组5.1%～27.0%,平均12.5%,非侵袭组3.6%～30.3%,平均16.2%,两组相比无明显差异(t=1.25,P=0.22).S/A(增殖凋亡细胞比值)侵袭组1.411,非侵袭组0.399,两者相比统计学差异明显(t=4.62,P<0.01),S/A高于1.411侵袭性诊断的灵敏性为60%,阳性预测值为100%.结论侵袭性腺瘤和非侵袭性腺瘤有着不同比例的增殖细胞和凋亡细胞,高增殖状态对侵袭性的诊断灵敏性较低,增殖和凋亡细胞比例失衡对侵袭性则具有更高的灵敏性和特异性.
목적 관찰수체선류적세포증식이급조망특성.탐토종류침습성적상관인소화조기진단지표.방법대수체류고정표본행Ki-67단극륭항체염색,응용류식세포의대신선수체류표본진행DNA배체화세포조망분석.결과고정표본48례,침습성선류28례,Ki-67고표체솔위13/28,비침습조고표체솔위6/20,량자상비통계학차이명현(χ~2=5.486,P=0.019),고표체대침습성진단적령민성위46.5%,양성예측치위68.3%.신선수체류표본33례,침습성선류15례,비침습성18례,비침습조S기세포비례위0.8%～12.2%,평균4.8%,침습조위3.9%～24.2%,평균13.0%,량자상비통계학차여명현(t=3.745,P=0.001),고우13.0%침습성진단적령민성위40%,양성예측치위100%;조망세포비례침습조5.1%～27.0%,평균12.5%,비침습조3.6%～30.3%,평균16.2%,량조상비무명현차이(t=1.25,P=0.22).S/A(증식조망세포비치)침습조1.411,비침습조0.399,량자상비통계학차이명현(t=4.62,P<0.01),S/A고우1.411침습성진단적령민성위60%,양성예측치위100%.결론침습성선류화비침습성선류유착불동비례적증식세포화조망세포,고증식상태대침습성적진단령민성교저,증식화조망세포비례실형대침습성칙구유경고적령민성화특이성.
Objective To investigate the proliferation and apoptosis characteristics of pituitary adenoma cells,and to discuss the relative factors of the invasiveness of the tumor and the early diagnosis.Methods Formalin-fixed samples of pituitary adenomas were immunohistochemically stained using Ki-67 monoclonal antibody.To the fresh samples,cell proliferation and apoptosis were analyzed with cytoflowmetry.Results Forty-eight formalin-fixed samples were studied,including 28 cases of invasive adenomas and the remaining 20 non-invasive.Positive stains of Ki-67 were found in 13 cases of invasive adenomas(13/28)and 6 in non-invasive ones(6/20,χ~2=5.486,P=0.019).With Ki-67 positive staining,the diagnosis sensitivity of invasive tumor was46.5%.the positive predictive value was 68.3%.Thirty-three fresh pituitary adenoma samples were studied,including 15 invasive and 18 non-invasive cases.S-phase fraction in invasive tumors was 3.9%-24.2%(average13.0%).while in non-invasive tumors it was 0.8%-12.2%(average 4.8%).Significant ditierence existed between two groups(t=3.745,P=0.001).The diagnosis sensitivity of invasiveness was 40%and the positive predictive value was 100%using the cup-point of>13.0%.The apoptosis cell percentage was 5.1%-27.0%(average 12.5%)in invasive and 3.6%-30.3%(average 16.2%)in non-invasive adenomas(t=1.25,P=0.22).The ratio of S-phase cells to apoptosis cells(S/A)were 1.411 and 0.399 in invasive and non-invssive groups,respectively(t=4.62,P<0.01).With s/A>1.411,the diagnosis sensitivity of invasiveness was 60%and the positive predictive value was 100%.Conclusions Between invasive and non-invasive pituitary adenomas.the proportions of proliferative cells and apoptosis cells seem to be different.High proliferation denotes poor sensitivity in diagnosing invasiveness,and imbalance between proliferation and apoptosis may be more sensitive and specific in regarding invasiveness.