单个核细胞分离在恶性胸水诊断中的临床研究  

Study on Clinical Value of the Mononuclear Cells Isolated From Pleural Effusions and Application in Differential the Diagnosis of Pleural Effusion of Malignant and Benign Origin

作　　者：马吉勇[1] 庞玉瑛[1] 朱钟鸣[1] 

机构地区：[1]安徽医科大学第一附属医院呼吸内科,安徽合肥230032

出　　处：《中国医师杂志》2002年第2期147-148,151,共3页Journal of Chinese Physician

摘　　要：目的　探讨包含肿瘤细胞的单个核细胞的分离在良恶性胸水诊断中的应用价值。方法　采用密度梯度离心法 ,使 5 0例恶性胸水中不同的细胞成分出现在percoll分离液的不同层面 ,分别吸取不同层面的细胞作涂片 ,HE染色 ,并与传统细胞病理学方法比较 ,计算各种方法病理细胞阳性率 ,各组间差异行 χ2 检验。结果　percoll分离液组 (Ⅰ组 ) ,离心沉渣涂片组 (Ⅱ组 ) ,直接涂片组 (Ⅲ组 )等三组病理细胞阳性率分别为 6 8% ,4 2 % ,12 % ,三组总卡方值 χ2 =32 5 5 ,P <0 0 1,总差异有显著性 ,其中Ⅰ组与Ⅱ组比较 :χ2 =5 82 ,P =0 0 16 ,差异有显著性 :Ⅱ组与Ⅲ组比较 :χ2 =12 5 7,P <0 0 1,差异有高度显著性 :Ⅰ组与Ⅲ组比较 :χ2 =32 34,P <0 0 1,差异有高度显著性。结论　胸水中单个核细胞包括淋巴细胞、单核细胞和肿瘤细胞 ,采用密度梯度离心法可以使上述三种细胞浓缩于单个核细胞层中 ,应用于良。Objective To investigate the clinical application value for isolation of mononuclear cell that including tumor cells in differential diagnosis of malignant pleural effusions from benign ones.Methods Fifty patients with malignant pleural effusions were included in this study.All pleural effusions were tested by density gradient centrifugation assay,traditional centrifugation smear assay,direct smear assay respectively,positive rate of pathologic cells was calculated out and evaluated intergroups difference by chi-square test in each method.Results Positive rates of pathologic cells in density gradient centrifugation group (groupⅠ),centrifugation smear group(groupⅡ) and direct smear group(groupⅢ) were 68%,42% and 12% respectively.Total difference was significant(χ 2=32.55,P<0.01),the difference between groupⅠ and groupⅡ was significant(χ 2=5.82,P=0.016) while groupⅡ and groupⅢ was very significant(χ 2=12.57,P<0.01),there was also very significant difference between groupⅠ and groupⅢ (χ 2=32.34,P<0.01).Conclusions Density gradient centrifugation assay can raise positive rates of differential diagnosis for malignant pleural effusions and be helpful to diagnosis of suspecting pleural effusions.

关 键 词：单个核细胞 诊断 恶性胸水 癌症 

分 类 号：R446.19[医药卫生—诊断学]