流式细胞术在恶性胸腔积液诊断中的价值  

Diagnostic Value of Flow Cytometry in Malignant Pleural Effusions

作　　者：郭纪全[1] 陈正贤[1] 王随照[1] 

机构地区：[1]广东省人民医院呼吸科,510080

出　　处：《实用癌症杂志》2000年第1期46-48,共3页The Practical Journal of Cancer

摘　　要：目的　探讨胸腔积液脱落细胞ＤＮＡ 定量分析对恶性胸腔积液的诊断价值。方法　采用流式细胞仪（ＦＣＭ） 对７２ 例恶性胸腔积液和５８ 例良性胸腔积液做ＤＮＡ 定量分析，并同时与胸膜活检病理诊断，胸腔积液细胞学诊断及胸腔积液ＣＥＡ 测定等方法相比较。结果　以异倍体阳性为标准，ＦＣＭ 诊断恶性胸腔积液的敏感性为８０ ．６ ％ ，特异性为１００ ．０ ％ ，与胸膜活检病理诊断（８６ ．１ ％ ） 相比较，无显著性差异（ Ｐ＞ ０ ．０５） ，但显著高于胸腔积液细胞学诊断（３６ ．１ ％ ） 及胸腔积液ＣＥＡ 测定（５０ ．０ ％ ） 的阳性率（ Ｐ均＜ ０ ．０１） 。在７２ 例恶性胸腔积液中，有６ 例胸膜活检病理诊断和胸腔积液细胞学诊断均为阴性而异倍体却为阳性，若４ 种方法相结合，其诊断的阳性率达９８ ．０ ％ ，特异性为１００ ．０ ％ 。结论　采用流式细胞仪（ＦＣＭ） 进行胸腔积液脱落细胞ＤＮＡ 定量分析是诊断恶性胸腔积液有效的辅助方法，可弥补病理诊断及细胞学诊断的不足。Objective To assess the diagnostic value of flow cytometric DNA quantitative analysis in malignant pleural effusions.Methods 72 cases of malignant pleural effusion and 58 cases of benign pleural effsions were analyzed by flow cytometry(FCM).The diagnostic value of FCM was evaluated and in comparison with pleural biopsy,conventional cytology and CEA detection in effsions.Results The presence of aneuploidy was used as a diagnostic criterion of malignant effusions,the sensitivity of FCM was 80.6%,the specificity was 100.0%,and there was no statistical difference when compared with pleural biopsy(86.1%)( P >0.05),but it was significantly higher than that of conventional cytology(36.1%)( P <0.01) and CEA detection(50.0%)( P <0.01).In 72 cases of malignant pleural effusions,pleural biopsy and conventional cytology of 6 cases appeared negative,but aneuploidy was obtained by FCM.The combined sensitivity of four methods was 98.0%,and the specificity was 100.0%.Conclusion These findings indicated that FCM may be a valuable adjunctive method in the diagnosis of malignant pleural effusions.

关 键 词：恶性胸腔积液 诊断 流式细胞术 

分 类 号：R730.4[医药卫生—肿瘤]