p16基因甲基化联合脱落细胞检查在恶性胸腔积液诊断中价值  

Value of detection of p16 gene methylation combined with exfoliative cytologic examination to the diagnosis of malignant pleural effusion

作　　者：刘大鹰 胡灼君 胡红波 

机构地区：[1]柳铁中心医院呼吸内科,广西壮族自治区柳州市545007 [2]柳铁中心医院检验科,广西壮族自治区柳州市545007

出　　处：《中华实用诊断与治疗杂志》2011年第7期667-669,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：广西壮族自治区科技厅基金(0719006-2-28)

摘　　要：目的:探讨胸腔积液沉渣细胞p16基因甲基化状态检测联合脱落细胞检查在良、恶性胸腔积液鉴别诊断中意义。方法:66例胸腔积液患者,其中恶性胸腔积液36例(恶性组),良性胸腔积液30例(良性组)。采用甲基化特异性PCR方法检测胸腔积液沉渣细胞p16基因的甲基化状态,同时进行胸腔积液脱落细胞检查,分析2种方法对胸腔积液诊断的意义。结果:p16基因甲基化、脱落细胞学检查和二者联合检查的阳性率恶性组分别为69.4%,41.7%和88.9%;良性组分别为13.3%,0,13.3%;2组比较差异均有统计学意义(P<0.05)。联合检查的敏感性为88.9%,特异性为86.7%,准确性为87.9%,2种方法联合检查优于单项检查(P<0.05)。结论:胸腔积液p16基因甲基化联合脱落细胞学检查对良、恶性胸腔积液有鉴别诊断价值。Objective To investigate the diagnostic value of the exfoliative cytologic examination combined with p16 gene methylation in the sediment of pleural effusion.Methods In 66 cases of pleural effusion,there were 36 cases of malignant and 30 cases of benign pleural effusion.Methylation-specific PCR（MSP） was used to detect p16 gene methylation and examination of exfoliative cytology was done in the sediment of pleural effusion.The diagnosis value of these two methods to pleural effusion was analyzed.Results The positive rates of p16 gene methylation examination,exfoliative cytologic examination and the combination of the two methods were 69.4%,41.7% and 88.9% in malignant pleural effusion patients,and were 13.3%,0 and 13.3% in benign pleural effusion patients,which showed significant differences between two groups（P0.05）.The diagnostic sensitivity,specificity and accuracy of the combination detection in malignant pleural effusion patients were 88.9%,86.7% and 87.9%.The combination detection was superior to either p16 gene methylation or exfoliative cytologic examination（P0.05）.Conclusion Exfoliative cytologic examination combined with p16 gene methylation detection has a clinical value to the differentiation of malignant from benign pleural effusion.

关 键 词：胸腔积液 DNA甲基化 P16基因 脱落细胞诊断 

分 类 号：R561.3[医药卫生—呼吸系统]