末梢血活性氧毒性物在肝癌诊断中的价值

目的:通过多媒体显微镜对肝硬化和肝癌患者手指血干血滴镜下活性氧毒性物(ROTS)形态和内含物的观察,探讨其在肝癌诊断中的价值．方法:选择临床确诊肝癌患者28例,肝硬化患者43例,其他癌症患者38例．制备手指血干血滴片,进行计算机扫描,应用高清晰度彩色病理图文分析系统(HPIAS-1000)对ROTS块的形状、内含物的情况进行观察比较．结果:肝癌患者28例中,有20例出现ROTS块的增大,其中15例在增大的ROTS块内可见到特异性刺突或者透明小体．肝硬化患者43例中,有16例出现ROTS块增大,其中8例出现刺突或者透明小体改变．以特异性刺突和／或透明小体为阳性标志,肝癌阳性率为53．6％,肝硬化阳性率为18．69,X2检验前者阳性率显著高于后者(P=0．0038)．观察其他癌症患者手指血涂片,均未见上述阳性改变．进一步研究发现,在肝癌患者中ROTS阳性和阴性患者血清唾液酸和AFP水平无显著性差异．ROTS阳性改变与患者年龄、转氨酶水平及肝功能Child-Pugh评分均无相关性．结论:肝癌患者手指血ROTS块在多媒体显微镜下呈现刺突和透明小体特异性改变,根据形态改变可以用以区分肝癌和肝硬化患者．

Values of reactive oxygen toxic species of finger blood dot in the diagnosis of hepatocellular carcinoma

AIM: To observe the morphology and inclusion body of reactive oxygen toxic species (ROTS) of finger blood dot in hepatocellular carcinoma (HCC) and liver cirrhosis (LC) by multimedia microscopy and explore its value in the diagnosis of HCC. METHODS: The finger blood dots were prepared from 28 patients with HCC, 43 patients with LC, 38 patients with other carcinomas. The blood dots were scanned and the morphology and inclusion body of ROTS were analyzed by high-vivid color pathology image analysis sys- tem(HPIAS-1000) between different groups of patients. RESULTS: The enlarged ROTS was detected in 20 of 28 patients with HCC and 16 of 43 patients with LC. Fifteen patients with HCC were found to have pricks, something like nails, or transparent body inside the enlarged ROTS, but only 8 patients with LC and no patients with other carcinomas showed ROTS morphological changes above. Regarding the pricks or transparent body as positive mark, the positive rate of HCC was 53.6%, significantly higher than that of LC (18.6%) (P = 0.0038). Further study indicated that the levels of serum sialic acid and alpha-fetopro-tein (AFP) in ROTS-positive patients with HCC were not significant higher than those of ROTS-negative ones. The ages of patients, the levels of alanine aminotransferase (ALT) and Child-Pugh grades for liver function were not significantly different between ROTS-positive and negative patients, either. CONCLUSION: ROTS of finger blood dots in HCC patient shows morphological changes of pricks and transparent body by multimedia microscopy, which can be used to differentiate most HCC from LC patients.