游离DNA完整性检测对良恶性胸腹腔积液鉴别诊断的价值研究

目的 探讨游离DNA(cfDNA)的完整性(ALU247/ALU115)检测对良恶性胸腹腔积液鉴别诊断价值.方法 采用实时荧光定量PCR方法,测定86份良恶性胸腹腔积液标本中ALU115和ALU247片段浓度并计算完整性;同时对标本中LDH、AFP、CEA、SF、SCC等传统指标进行检测.绘制受试者工作曲线(ROC曲线),根据曲线下面积评估各标记物诊断意义;运用统计学方法,与传统指标进行对比,评价cfDNA完整性在良恶性胸腹腔积液鉴别诊断中的应用价值.结果 恶性组DNA完整性指数(ALU247/ALU115)显著高于良性组,差异具有统计学意义(P<0.01),ROC曲线下面积为0.70.cfDNA浓度和完整性联合检测的灵敏度、特异度及准确度均显著高于其他各项指标单独或联合检测.该联合检测方式与cfDNA联合传统指标在鉴别诊断良恶性胸腹腔积液方面比较差异无统计学意义.结论 cfDNA完整性检测是良恶性胸腹腔积液鉴别诊断可能的良好靶标.ALU115、ALU247片段浓度和完整性(ALU247/ALU115)三项联合检测诊断价值更高.

The application of free DNA test in differential diagnosis of benign and malignant pleural effusion

Objective o investigate the significance of the cell-free DNA (cfDNA) integrity detection in differential diagnosis of benign and malignant pleural effusions.Methods By real-time quantitative PCR method, ALU115bp and ALU247bp repetitive sequences were detected on 86 samples of benign and malignant pleural effusion.LDH, AFP, CEA, SF, SCC and other traditional indicators of the specimens were also tested.Receiver operating characteristic curve (ROC) was drawn in accordance with tumor marker levels of pleural effusions, and the diagnostic significance was evaluated by the area under the curve.The application value of cfDNA integrity detection in differential diagnosis of benign and malignant pleural effusion was evaluated by compared with the traditional indicators.Results DNA integrity indicators were significantly higher in malignant group than those in benign group (P<0.01), with the area under ROC of 0.7.The combination detection of cfDNA concentration and integrity was significantly superior than the single detection or combination detection of the other indicators in sensitivity, specificity and accuracy.Conclusion CfDNA integrity test provides significant diagnostic value in the differential diagnosis of benign and malignant pleural effusion.