DNA定量分析检测对胸腔积液的诊断价值研究(1)
摘 要：目的 探讨细胞DNA定量分析在不明原因胸水诊断中的应用价值。方法 收集本院2015年9月～2016年3月122例胸腔积液患者抽取胸水，标本制片后分别经巴氏染色行脱落细胞学检查，Feulgen染色后行细胞DNA定量分析。结果 122例胸腔积液中有56例恶性胸腔积液，66例良性胸腔积液。细胞学检测恶性胸水敏感度为82.14%，特异性为98.48%，阳性预测值97.87%，阴性预测值86.67%。细胞DNA定量分析检测恶性胸水敏感度为80.36%，特异度为90.91%，阳性预测值88.24%，阴性预测值84.51%。两种方法诊断结果一致性一般(Kappa=0.473，P<0.001)，差异无统计学意义(P=1.0)。结论 DNA定量分析检测是一种较敏感而特异的肺癌的筛查技术，DNA异倍体有望作为良恶性胸水诊断有价值的标志物。
关键词：胸腔积液；细胞学检查；细胞DNA定量分析
中图分类号：R450 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.021
, http://www.100md.com
文章编号：1006-1959(2018)06-0066-04
Quantitative Analysis of DNA for Diagnosis of Pleural Effusion
WANG Min，JIANG Tao
(Department of Respiratory Medicine，The First Affiliated Hospital，Chongqing Medical University，Chongqing 400016，China)
Abstract：Objective To evaluate the value of DNA quantitative analysis in the diagnosis of unexplained hydrothorax.Methods A total of 122 patients with pleural effusion were collected from our hospital in September 2015～March 2016.After taking the tablets， they were stained by PAP staining and cytological examination.After Feulgen staining， cell DNA was quantitatively analyzed.Results There were 56 cases of malignant pleural effusion and 66 cases of benign pleural effusion in 122 cases of pleural effusion.The sensitivity of malignant pleural effusion was 82.14%，the specificity was 98.48%，the positive predictive value was 97.87%，and the negative predictive value was 86.67%.The sensitivity of DNA in malignant pleural effusion was 80.36%，the specificity was 90.91%，the positive predictive value was 88.24%，and the negative predictive value was 84.51%.The results of the two methods were consistent(Kappa=0.473， P<0.001)，and the difference was not statistically significant(P=1.0).Conclusion DNA quantitative analysis is a sensitive and specific screening technology for lung cancer.DNA aneuploidy is expected to be a valuable marker for the diagnosis of benign and malignant pleural effusion.
, 百拇医药
Key words：Pleural effusion；Cytological examination；Quantitative analysis of cell DNA
近年來，肺癌已成为全球最主要的癌症死亡原因，其总患病率为130.2/10万[1]。恶性胸腔积液为肺癌常见的并发症之一，约57%的肺癌患者在初诊时已发生了远处转移[2]。故胸腔积液的良恶性鉴别在临床上具有协助疾病诊断、指导治疗的意义。目前临床上鉴别良恶性胸腔积液常依靠胸水细胞学检查，其主要依靠细胞形态学进行定性诊断，但该检查对高度增生的间皮细胞、增生性间皮细胞，肿瘤的间皮细胞和转移性腺癌细胞的鉴别诊断较为困难[3]。目前采用液基细胞学检查(liquid-based cytology，LBC)行脱落细胞学检查，较传统涂片在病理学诊断阳性率有所提高[4]。本研究应用DNA定量分析(DNA image cytometry，DNA-ICM)检测胸腔积液中的细胞异倍体，并与脱落细胞学结果相对比，以探讨该检测方法在良恶性胸腔积液中的诊断价值。
1 材料与方法
1.1研究对象 收集本院2015年9月～2016年3月胸腔积液标本122例，其中男77例，女45例，年龄22～95岁，所有病例均经组织病理学、影像学、实验室检查并结合临床诊断明确。全部患者胸腔积液均同时行脱落细胞学检查和细胞DNA定量检测。, http://www.100md.com(王敏 江涛)
关键词：胸腔积液；细胞学检查；细胞DNA定量分析
中图分类号：R450 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.021
, http://www.100md.com
文章编号：1006-1959(2018)06-0066-04
Quantitative Analysis of DNA for Diagnosis of Pleural Effusion
WANG Min，JIANG Tao
(Department of Respiratory Medicine，The First Affiliated Hospital，Chongqing Medical University，Chongqing 400016，China)
Abstract：Objective To evaluate the value of DNA quantitative analysis in the diagnosis of unexplained hydrothorax.Methods A total of 122 patients with pleural effusion were collected from our hospital in September 2015～March 2016.After taking the tablets， they were stained by PAP staining and cytological examination.After Feulgen staining， cell DNA was quantitatively analyzed.Results There were 56 cases of malignant pleural effusion and 66 cases of benign pleural effusion in 122 cases of pleural effusion.The sensitivity of malignant pleural effusion was 82.14%，the specificity was 98.48%，the positive predictive value was 97.87%，and the negative predictive value was 86.67%.The sensitivity of DNA in malignant pleural effusion was 80.36%，the specificity was 90.91%，the positive predictive value was 88.24%，and the negative predictive value was 84.51%.The results of the two methods were consistent(Kappa=0.473， P<0.001)，and the difference was not statistically significant(P=1.0).Conclusion DNA quantitative analysis is a sensitive and specific screening technology for lung cancer.DNA aneuploidy is expected to be a valuable marker for the diagnosis of benign and malignant pleural effusion.
, 百拇医药
Key words：Pleural effusion；Cytological examination；Quantitative analysis of cell DNA
近年來，肺癌已成为全球最主要的癌症死亡原因，其总患病率为130.2/10万[1]。恶性胸腔积液为肺癌常见的并发症之一，约57%的肺癌患者在初诊时已发生了远处转移[2]。故胸腔积液的良恶性鉴别在临床上具有协助疾病诊断、指导治疗的意义。目前临床上鉴别良恶性胸腔积液常依靠胸水细胞学检查，其主要依靠细胞形态学进行定性诊断，但该检查对高度增生的间皮细胞、增生性间皮细胞，肿瘤的间皮细胞和转移性腺癌细胞的鉴别诊断较为困难[3]。目前采用液基细胞学检查(liquid-based cytology，LBC)行脱落细胞学检查，较传统涂片在病理学诊断阳性率有所提高[4]。本研究应用DNA定量分析(DNA image cytometry，DNA-ICM)检测胸腔积液中的细胞异倍体，并与脱落细胞学结果相对比，以探讨该检测方法在良恶性胸腔积液中的诊断价值。
1 材料与方法
1.1研究对象 收集本院2015年9月～2016年3月胸腔积液标本122例，其中男77例，女45例，年龄22～95岁，所有病例均经组织病理学、影像学、实验室检查并结合临床诊断明确。全部患者胸腔积液均同时行脱落细胞学检查和细胞DNA定量检测。, http://www.100md.com(王敏 江涛)