免疫磁珠技术检测癌症患者胸腹水  

Detection of hydrothorax or ascites in patients with cancers using immunomagnetic beads technique

作　　者：王文秀[1] 杨艳丽[2] 于泽 徐玉清[1] 

机构地区：[1]哈尔滨医科大学第二附属医院肿瘤内科,黑龙江哈尔滨150086 [2]哈尔滨医科大学病理生理学教研室,黑龙江哈尔滨150086 [3]烟台市职业病肿瘤医院,山东烟台202600

出　　处：《中国癌症杂志》2008年第9期685-688,共4页China Oncology

摘　　要：背景与目的:目前常规的脱落细胞病理学检查为临床诊断恶性胸腹水的金标准,但其漏诊率较高。其他方法,如免疫学检查、端粒酶活性检测、染色体分析结合细胞学检查、RT-PCR检测等或因所需的费用较昂贵,或因检出的假阳性率较高而未被推广。免疫磁珠技术主要应用于细胞的分离、纯化。目前国内外尚少见应用此技术检测癌症患者胸腹水的研究。本实验旨在研究用免疫磁珠技术检测癌症患者胸腹水中的肿瘤细胞,以提高恶性胸腹水的诊断率。方法:分别用免疫磁珠技术、常规脱落细胞学方法检测30例癌症患者和30例非癌症患者的胸腹水,比较两种方法的检出率及假阳性率。结果:在癌症患者,免疫磁珠法的肿瘤细胞检出率为63.3%(19/30),显著高于常规脱落细胞学法(23.3%,7/30)(P<0.01);在非癌症患者,免疫磁珠技术检出的的假阳性率(3.3%,1/30)与常规脱落细胞学的假阳性率(0.0%,0/30)相比差异无显著性(P>0.05)。结论:免疫磁珠技术是一种准确﹑快速﹑灵敏度高的检测癌症患者胸腹水的方法。如在常规脱落细胞病理学检测阴性结果后应用此方法,将大大提高临床合并有胸腹水的癌症患者的诊断率。Background and purpose： Nowadays, the golden standard of diagnosis for malignant hydrothorax or ascites is exfoliocytology examination, but the missed diagnosis rate is too high. Other methods including immunologic test, telomerase activation test, conjugation of chromosome analysis with cytological examination test, and RT-PCR test. But none of them was widely used due to high cost or high false positive rate. Immunomagnetic beads （IMB） technique is a popular method all over the world in recent years. It was mainly used in isolating and purifying cells, but it was rarely used to detect cancer cells in patients with hydrothorax or ascites so far. Our aim was to find an efficient way to detect the cancer cells in patients with cancer related hydrothorax or ascites and to improve the corresponding diagnosis rate. Methods： In the experiments, both the traditional exfoliocytology examination method and IMB technique were used to detect the cancer cells in the hydrothorax or the ascites for comparison. Results： Using IMB technique and exfoliocytology method, the positive rates in 30 patients with cancers were 63.3% （19/30） and 23.3% （7/30）, respectively, and the false positive rates in 30 patients without cancers were 3.3% （1/30） and 0.0% （0/30）, respectively. It could be observed that the positive rate using IMB technique was much higher than that using exfoliocytology method （P〈0.01）, and there is no significant difference between the false positive rates using the two methods（P〉0.05）. Conclusions： The present study demonstrated that IMB technique is an accurate, sensitive, fast and economic method in detecting the cancer cells in patients with cancer related hydrothorax or ascites, especially for diagnosis and therapy in the early clinical stage. Due to the high efficiency, IMB technique could be used after exfoliocytology examination to improve the diagnosis rate..

关 键 词：免疫磁珠 肿瘤细胞 胸水 腹水 

分 类 号：R730.45[医药卫生—肿瘤]