检测DNA异倍体对恶性胸腔积液的诊断价值

目的 探讨流式细胞检测DNA异倍体对恶性胸腔积液的诊断价值。方法 恶性胸积液41例均经临床与病理证实结核性胸腔积液40例为对照组。各例均作流式细胞DNA异倍体检测与癌胚抗原测定。结果 肿瘤组中33例胸水流式细胞DNA异倍体呈阳性。8例呈阴性，假阴性率为19.5%，30例胸水CEA呈阳性，11例呈阴性，假阴性率为26.8%。结核组中36例胸水流式细胞DNA异倍体呈阴性。4例呈阳性，假阳性率为11.1%。34例胸水CEA阴性，6例阳性，假阳性率为17.6%，胸水流式细胞DNA异倍体诊断的敏感性为80.5%、特异性90%、准确性85.2% ；胸水CEA诊断的敏感性为732%、特异性85%、准确性79%；两项检测联合应用诊断的敏感性为927%、特异性100%、准确性96.3%。结论 流式细胞DNA异倍体检测对于诊断恶性胸腔积液具有良好的临床价值。其诊断敏感性、特异性和准确性均高于胸水CEA的诊断，若联合两项检测方法诊断恶性胸腔积液则具有更好的临床价值。

Diagnostic application of the DNA heteroploid detection with flow cytometry to the malignant pleural effusion

Objective To investigate the diagnostic value of the DNA heteroploid detection with flow cytometry to the malignant pleural effusion.Methods All the 41 patients with malignant pleural effusion were diagnosed with clinical and pathological features form the tumor group,40 patients with tuberculous pleural effusion formed the control group.All the patients'pleural effusion was detected by the DNA heteroploid detection with flow cytometry and CEA detection.Results In the tumor group,the 33 results of the DNA heteroploid detection were positive and the other 8 ones were negative,the false negative percentage was 19.5%.30 results of CEA detection were positive and 11 ones were negative;the false negative percentage was 26.8%.In the control group,the 36 results of the DNA heteroploid detection were negative and the other 4 ones were positive,the false positive percentage was 11.1%.34 results of CEA detection were negative and 6 ones were positive;the false positive percentage was 17.6%.The sensitivity of the DNA heteroploid detection with flow cytometry was 80.5%,the specificity was 90% and the accuracy was 85.2%.The sensitivity of the CEA detection was 73.2%,the specificity was 85% and the accuracy was 79%.The sensitivity of the combination of the two detections was 92.7%,the specificity was 100% and the accuracy was 96.3%.Conclusions The DNA heteroploid detection with flow cytometry has good clinical application to diagnosis of the malignant pleural effusion.Its sensitivity,specificity and accuracy are more than the ones of CEA detection respectively.There are better clinical application if combine the two detective methods.