胸腔积液及腹水染色体检测对良恶性胸腔积液及腹水的辅助诊断  

Hydrothorax and ascites chromosome detection aided diagnosis of benign and malignant pleural effusion

作　　者：王欢[1] 邱瑞霞[1] 梁大力[1] 王娟[1] 叶杰英[1] 

机构地区：[1]广东省清远市人民医院,511518

出　　处：《检验医学与临床》2012年第21期2681-2682,共2页Laboratory Medicine and Clinic

摘　　要：目的探讨胸腔积液及腹水染色体检测在鉴别良、恶性胸腔积液及腹水中的作用,以便用于辅助临床良、恶性胸腔积液及腹水的诊断与鉴别诊断。方法对90例胸腔积液及腹水,包括良、恶性胸腔积液及腹水应用细胞遗传学短期培养法,G显带、染色体直接制片法,以中期分裂象细胞超二倍体和多倍体大于或等于10%为恶性积液,腺苷脱氨酶(ADA)<25U/L为恶性胸腔积液及腹水诊断标准,乳酸脱氢酶(LDH)>300U/L为阳性标准,癌胚抗原(CEA)>15μg/L为恶性胸腔积液及腹水诊断标准。结果胸、腹水染色体短期培养法成功率为81.1%,在恶性胸腔积液及腹水中出现多倍体的特异性为100.0%;ADA在非恶性胸腔积液及腹水的敏感性为22.9%,在恶性胸腔积液及腹水中的敏感性为100.0%,但无特异性;LDH在恶性胸腔积液及腹水中的阳性率为90.1%,在非恶性胸腔积液及腹水的敏感性为32.6%;CEA在恶性胸腔积液及腹水中的阳性率为63.6%。结论采用胸腔积液及腹水细胞遗传学短期培养方法,与染色体直接制片法检测,有利于提高良、恶性胸腔积液及腹水的诊断和鉴别诊断。Objective To approach best method of the hydrothorax and ascites chromosome in benign and malignant hydrothorax,for helping to diagnose and differentiate clinical benign and malignant the hydrothorax.Methods Cytogenetical short-term culture method was used for 90 case the about hydrothoraxs and the ascites chromosomes,chromosome routine making slide and G show belt.The malignant standard of chromosome exam was that the number of the hyperdiploid and polyploidy in metaphase splited cell≥10%,ADA25 U/L,LDH300 U/L,CEA15 μg/L.Results The chromosome short-term culture method success rate was 81.1%,in malignant the hydrothorax and ascites the specificity of appearing polyploid was 100%.ADA in Non-malignant hydrothorax and ascites sensitivity was 22.9%,in malignant the hydrothorax and ascites the specificity was 100% and not specificity.LDH in malignant the hydrothorax and ascites positive rate was 90.1%,in non-malignant hydrothorax and ascites sensitivity was 32.6%.CEA in malignant the hydrothorax and ascites sensitivity was 63.6%.Conclusion Using hydrothorax and ascites cytogenetical short-term culture method and chromosome direct producer method can help to improve the diagnose and differentiate benign and malignant hydrothorax and ascites.

关 键 词：胸腔积液及腹水染色体 腺苷脱氨酶 乳酸脱氨酶 癌胚抗原 良恶性胸腹腔积液 

分 类 号：R561.3[医药卫生—呼吸系统]