核仁组成区嗜银蛋白联合流式细胞术-DNA倍体分析对良恶性胸腹水鉴别诊断的临床价值  

Significance of AgNOR and DNA ploidy pattern as diagnostic adjuncts to differentiate malignant from benign serous effusions

作　　者：吴丽颖[1] 刘邦荣[1] 陆军[1] 凌明德[1] 李朋[1] 王兴鹏[2] 

机构地区：[1]淮北市人民医院,安徽淮北235000 [2]上海交通大学附属第一医院消化科

出　　处：《临床内科杂志》2006年第4期242-245,共4页Journal of Clinical Internal Medicine

基　　金：安徽省淮北市科技计划基金项目资助(项目编号040143)

摘　　要：目的采用联合应用核仁组成区嗜银蛋白(AgNOR)和流式细胞术(FCM)-DNA倍体分析,以探讨其对良恶性胸腹水的鉴别诊断价值。方法选取自2004年6月起因胸腹水来我院就诊的患者共67例进行前瞻性分析。每位患者除常规胸腹水脱落细胞学检查外,均进行AgNOR染色和FCM-DNA倍体分析检测。结果恶性胸腹水与良性胸腹水AgNOR每核颗粒平均数分别为4.33±0.68和1.57±0.48(P<0.05);AgNOR染色敏感性为89.1%,特异性为90.1%;胸腹水细胞DNA倍体分析检查敏感性为71.7%,特异性为95.2%;DNA倍体分析与AgNOR检测具有一定的相关性,联合检测的敏感性为91.5%,特异性为95.3%。结论DNA倍体分析异常与AgNOR颗粒数增多均与恶性胸腹水相关,二者联合检测比单项检测更有助于胸腹水性质的鉴别诊断。Objective To explore the clinical value of AgNOR combined with FCM-DNA ploidy pattern in differentiating malignant from benign serous effusions. Methods Sixty-seven patients with serous effusions were analyzed in our hospital from June 2004. AgNOR staining and FCM-DNA ploidy were examined besides routine exfoliated cytology study. Results The mean number of AgNOR dots in malignant serous effusions and benign ones was 3.33 ± 0.68 and 1.57 ± 0.34 respectively, with a sensitivity of 89.1% and a specificity of 90.1%. DNA analysis had a sensitivity of 71.7% and a specificity of 95.2%. There was a significant correlation between FCM-DNA ploidy and the mean number of AgNORs per nucle- us in malignant cases. The combination of both had a sensitivity of 91.5% and a specificity of 95.3%. Conclusious Both DNA aneuploid and AgNOR counting are correlated with malignant serous effusions, the combination of both was more helpful to differenciating the malignancy from benign ones.

关 键 词：核仁组成区嗜银蛋白 DNA倍体分析 胸腹水 

分 类 号：R450[医药卫生—治疗学]