Value of automatic DNA image cytometry for diagnosing lung cancer

Abstract

The present study aimed to investigate the diagnostic value of automatic DNA image cytometry (DNA-ICM) for diagnosing lung cancer. A total of three different types of samples from 465 cases were included: Bronchoalveolar lavage fluid (BALF), 386 samples; pleural effusion cases, 70 samples; and fine-needle aspiration procedures, 9 samples. Two methods, liquid-based cytology (LBC) and automatic DNA-ICM, were used to assess the samples, and the pathological results of 120/465 cases were reviewed. The results of DNA-ICM were compared with those of LBC and pathology. There were 57 cases of lung cancer without aneuploidy and 49 cases without evidence of malignant tumor, but with the presence of heteroploid cells. The positive diagnostic rate for BALF samples using LBC was significantly higher compared with that for DNA-ICM (P<0.05). No statistically significant difference was observed in the positive diagnostic rate between DNA-ICM and LBC in pleural effusion samples. For DNA-ICM in BALF, pleural effusion and all samples, no statistically significant differences were identified between the positive diagnostic rates of lung squamous carcinoma and lung adenocarcinoma. The positive diagnostic rate of LBC combined with DNA-ICM was not significantly improved. In non-small cell lung cancer (NSCLC) cases, the difference in the maximum value of DNA (DNAmax) was positively correlated with tumor stage (P<0.05), but no significant correlations were observed among DNA max, tumor type and tumor location. In small-cell lung cancer (SCLC) cases, no significant correlations were observed among DNAmax, tumor staging or tumor location. The differences in the DNAmax values of squamous cell carcinoma, adenocarcinoma, SCLC and NSCLC were not statistically significant. In the present study, the area under the receiver operating characteristic curve for LBC (0.936) was significantly greater compared with that for DNA-ICM (0.766) (P<0.05). DNA-ICM has medium diagnostic value in lung cancer, and the DNAmax was positively correlated with tumor stage in NSCLC. DNA-ICM may serve as a supplement to LBC, but it is not recommended as a sole procedure for lung cancer screening.

DNA image cytometric analysis of bronchial washings as an adjunct for the detection of lung cancer in a clinical setting

“…In some lung cancer cases, it was reported that the bronchial washings were positive detected by DNA‐ICM while negative by conventional cytology. 23 We speculate that the advantage of DNA‐ICM in sensitivity offsets the disadvantage of sampling issues in patients with invisible endobronchial tumor, hence there was no significant difference in the positive rate of DNA‐ICM between the visible tumor group and the invisible tumor group.…”

“…Four relevant studies were found. 6 , 23 , 29 , 30 From the literature review, the sensitivity of DNA‐ICM was 69.05%~90%, and the specificity was 80.28%~100% (Table 5 ). To our knowledge, this is the largest research on the application of DNA‐ICM analysis of bronchial washings in lung cancer diagnosis.…”

“…Most studies suggest that the threshold for assuming malignancy is the existence of more than three nuclei with DNA content greater than 5c. 11 , 23 , 24 , 25 Schramm et al 6 favor the identification of abnormal position of any DNA stemline and/or at least one cell with a DNA content >9c as the diagnostic criteria for lung cancer, since octaploid cells rarely occur in noncancerous epithelium of inflamedlungs. 15 Therefore, the positive indicators for DNA‐ICM in our study were three or more cells >5c and/or occurrence of at least one cell >9c.…”

DNA aneuploidy combined with radial EBUS in the diagnosis of peripheral lung lesions

“…DNA‐ICM is a promising screening tool for early lung cancer in high‐risk group 27 . Nevertheless, it was still controversial for diagnosis of lung cancer since some studies yielded inconsistent results 28,29 . This study focused on its diagnosis value in PPLs, which has rarely been reported.…”

Clinical Evaluation of DNA Ploidy for the Triage of HPV-Positive Chinese Women During Cervical Cancer Screening

“…Recent research evaluated the cost-effectiveness of DNA ploidy analysis for cervical screening compared with Pap cytology and considered that DNA ploidy strategy appeared to be less costly and comparably effective [19]. The technology of DNA ploidy analysis has become well-established for diagnostic use in several tumors such as endometrial cancer and lung cancer [20,21]. Inexpensive and semiautomated features of DNA ploidy measurement made it an ideal alternative for triaging HPV-positive women in China and other developing countries.…”