胸腔积液及腹水染色体检测对良恶性胸腔积液及腹水的辅助诊断

目的探讨胸腔积液及腹水染色体检测在鉴别良、恶性胸腔积液及腹水中的作用,以便用于辅助临床良、恶性胸腔积液及腹水的诊断与鉴别诊断。方法对90例胸腔积液及腹水,包括良、恶性胸腔积液及腹水应用细胞遗传学短期培养法,G显带、染色体直接制片法,以中期分裂象细胞超二倍体和多倍体大于或等于10%为恶性积液,腺苷脱氨酶(ADA)<25U/L为恶性胸腔积液及腹水诊断标准,乳酸脱氢酶(LDH)>300U/L为阳性标准,癌胚抗原(CEA)>15μg/L为恶性胸腔积液及腹水诊断标准。结果胸、腹水染色体短期培养法成功率为81.1%,在恶性胸腔积液及腹水中出现多倍体的特异性为100.0%;ADA在非恶性胸腔积液及腹水的敏感性为22.9%,在恶性胸腔积液及腹水中的敏感性为100.0%,但无特异性;LDH在恶性胸腔积液及腹水中的阳性率为90.1%,在非恶性胸腔积液及腹水的敏感性为32.6%;CEA在恶性胸腔积液及腹水中的阳性率为63.6%。结论采用胸腔积液及腹水细胞遗传学短期培养方法,与染色体直接制片法检测,有利于提高良、恶性胸腔积液及腹水的诊断和鉴别诊断。

Hydrothorax and ascites chromosome detection aided diagnosis of benign and malignant pleural effusion

Objective To approach best method of the hydrothorax and ascites chromosome in benign and malignant hydrothorax,for helping to diagnose and differentiate clinical benign and malignant the hydrothorax.Methods Cytogenetical short-term culture method was used for 90 case the about hydrothoraxs and the ascites chromosomes,chromosome routine making slide and G show belt.The malignant standard of chromosome exam was that the number of the hyperdiploid and polyploidy in metaphase splited cell≥10%,ADA25 U/L,LDH300 U/L,CEA15 μg/L.Results The chromosome short-term culture method success rate was 81.1%,in malignant the hydrothorax and ascites the specificity of appearing polyploid was 100%.ADA in Non-malignant hydrothorax and ascites sensitivity was 22.9%,in malignant the hydrothorax and ascites the specificity was 100% and not specificity.LDH in malignant the hydrothorax and ascites positive rate was 90.1%,in non-malignant hydrothorax and ascites sensitivity was 32.6%.CEA in malignant the hydrothorax and ascites sensitivity was 63.6%.Conclusion Using hydrothorax and ascites cytogenetical short-term culture method and chromosome direct producer method can help to improve the diagnose and differentiate benign and malignant hydrothorax and ascites.