DNA倍体分析联合端粒酶活性检测对良恶性腹水的鉴别诊断价值

目的：探讨腹水细胞DNA倍体分析联合端粒酶活性检测对良、恶性腹水的鉴别诊断价值。方法：采用TRAP-PCR-ELISA法对96例腹水（良性腹水47例，恶性腹水49例）进行端粒酶活性半定量测定，用酶标仪（∑960型）测其在波长450nm的吸光度（A），以A〉0．20为阳性判断标准，同时进行腹水细胞DNA倍体分析。结果：（1）恶性腹水组细胞DNA倍体分析阳性率为81．36％（40／47），明显高于良性腹水组的2．13％（1／47），DNA倍体分析区别腹水良、恶性的敏感度为81．36％，特异度为97．87％；（2）恶性腹水组端粒酶活性（平均A值0．745）明显高于良性腹水组（平均A值0．065），端粒酶活性在恶性腹水组阳性率为91．84％（40／49），明显高于良性腹水组的4．26％．端粒酶活性检测区别腹水良、恶性的敏感度为91．84％，特异度为95．74％；（3）DNA倍体分析联合端粒酶活性检测对恶性腹水的诊断率为97．96％（48／49）。结论：DNA倍体分析联合端粒酶活性检测是鉴别良、恶性腹水敏感而特异的方法。

Differential Diagnostic Significance of Telomerase Activity and DNA Ploidy Analysis in the Malignant and Benign Ascites

Objective:To investigate differential diagnostic significance of telomerase activity and DNA ploidy analysis in the malignant and benign ascites.Methods:The technique of the quantity of TRAP-PCR-ELISA was employed to detect telomerase activity in the 49 cases of malignant ascites( group A)and 47 case of s benign ascites(group B). The result was analyzed on the basis of 450 nm absorbance(A) measured by the enzyme-linked apparatus(positive standard:A>0.200).DNA ploidy analysis was performed at the same time.Results:Positive rate of DNA ploidy analysis of group A (81.36%) was significantly higher than that of group B(2.13% ),(sensitivity:81.36%;specificity: 97.87%).Telomerase activity in group A(mean A 0.745)was significantly higher than that in group B (mean A 0.065),and positive rate of telomerase activity detected in group A(91.84%)was significantly higher than that in group B (4.26%),(sensitivity 91.84%;specificity:95.47%).If telomerase activity and DNA ploidy analysis were examined simultaneously,the diagnostic rate of malignant ascites was 97.96%(sensitivity :97.96%;specificity:100%).Conclusion:The combination of DNA ploidy analysis and telomerase activity is a specific and sensitive method in the differential diagnosis of malignant ascites,and benign ascites.