DNA异倍体测定对良恶性胸腔积液鉴别诊断价值的研究

目的探讨流式细胞术检测DNA异倍体对良恶性胸腔积液的诊断价值。方法选取胸腔积液住院病人50人,其中确诊恶性胸腔积液30人,良性胸腔积液20人。各例均行胸水脱落细胞学、流式细胞术DNA含量、胸水癌胚抗原（CEA）及腺苷脱氨酶（ADA）测定。结果恶性胸腔积液组异倍体阳性率73.3%;良性胸腔积液异倍体阳性率5.0%,两组相比有统计学意义（P（0.01）。恶性胸液组CEA平均值为（34.8±14.9）μg/L;良性胸液组CEA平均值为（4.7±1.5）μg/L,两组相比差异有统计学意义（P（0.01）。恶性胸液组ADA平均值为（27.1±10.8）IU/ml;良性胸液组ADA平均值为（52.7±22.2）IU/ml,两组相比差异有统计学意义（P（0.01）。流式细胞术DNA含量分析对恶性胸水诊断的敏感性为73.3%、特异性为85.0%;流式分析联合胸水CEA检测对恶性胸水诊断的敏感性提高到83.3%,特异性提高到100%。结论流式细胞术细胞DNA分析,是对细胞病理学、肿瘤标志物分析的有益补充,具有良好的临床应用价值。

The diagnostic value of FCM DNA content for benign and malignant pleural effusion

Objective To assess the diagnostic value of flow cytometry（FCM） DNA content analysis in benign and malignant pleural effusion.Methods Fresh pleural effusion were taken from 50 patients（30 malignant pleural effusion,20 benign pleural effusion）.All pleural effusion was measured for DNA heteroploid detection with flow cytometry.The diagnostic value of this method was compared with pleural CEA and ADA detection.Results The rate of DNA heteroploid was respectively 73.3% and 5% in malignant and benign pleural effusion（P0.01）.The average level of CEA was 4.7±1.5 ug/L in benign pleural effusion and 34.8±14.9 ug/L in malignant pleural effusion（P0.01）.The average level of ADA was 52.7±22.2 IU/ml in benign pleural effusion and 27.1±10.8 IU/ml in malignant pleural effusion（P0.01）.Sensitivity of DNA analysis was 73.3% and the specificity was 85%.Sensitivity and specificity of DNA analysis addition to pathological analysis can reach to 83.3% and 100%.Conclusions the FCM DNA content analysis has an adjunctive value in diagnosis of malignant pleural effusion and provides a beneficial method in differential diagnosis of pleural effusion.