胸腹水液基薄层细胞涂片中Ki-67的表达联合CA153、CYFRA211、CEA的检测与胸腹水良恶性质的相关性  

作　　者：王翠峰[1] 任美英[1] 付玉华[1] 杨丽[1] 

机构地区：[1]内蒙古包头医学院第一附属医院检验科,内蒙古014010

出　　处：《当代医学》2016年第6期1-4,共4页Contemporary Medicine

基　　金：包头市社会发展科技支撑项目(2011 S 2012-01-9)

摘　　要：目的本实验通过选用单克隆抗体Ki-67标记胸腹水液基薄层细胞涂片,并联合定量分析CA 153、CYFRA 211及CEA等三项肿瘤标志物在胸腹水中的含量,对比这几种检测指标的不同检测组合的效能评价来鉴别胸腹水的良、恶性质。方法本实验共收集恶性组胸腹水标本51例,良性组胸腹水标本34例,对每份标本部分采用免疫细胞化学染色法检测液基薄层细胞涂片中Ki-67表达及半定量分析,其余部分检测肿瘤标志物CA 153、CYFRA 211及CEA的含量,后分别对4项指标单独及联合检测的不同组合进行效能评价。结果恶性组中胸腹水Ki-67的表达分析及CYFRA 211、CEA含量均高于良性胸腔积液组,差异有统计学意义(P<0.05)。在效能评价中,4个项目单独检测胸腹水时,敏感度和阴性预测值最低的是CA 153、特异性最低的是CYFRA 211、阳性预测值最低的是CEA。当两两组合检测中Ki-67和CYFRA 211的敏感性最高,可达98.0%,但特异性最低。而Ki-67和CA 153联合检测,特异性尽管最高,达76.4%,但敏感性却最低,为88.3%。而在3项组合中,每种组合均可将敏感性提高到90.0%以上,但特异性却比单项检测或两两结合检测的结果均低。而当以上4项指标共同联合检测时敏感度为100.0%,而特异性却为几种检测方式中的最低,为44.1%。结论分析所测结果,细胞免疫组化Ki-67的表达联合CEA、CYFRA 211检测可将恶性胸腹水诊断的敏感性提高到98.0%,而特异性也可达到70.5%,从而成为在鉴别胸腹水良、恶性质中最大互补作用的项目组合。Objective In this study, the choice of ki-67 monoclonal antibody marked pleural effusion and ascites＇ s cells smears by Thin- layer cytology test, and combining the quantitative analysis of joint CA 153, CYFRA 211 and CEA, such as three levels of tumor marker in pleural effusion and ascites, Comparative Effectiveness evaluation of combination of several different detection indicators to identify benign and malignant nature of pleural effusion and ascites. Methods In this study, samples were collected of 51 cases of malignant pleural and peritoneal effusions as the malignant group, and collected of 34 cases of benign pleural and peritoneal effusions as the benign group. Part of each samples Use immunohistochemical staining method to detect expression of Ki-67 in cells smears of malignant group and benign group by Thin-layer cytology test and semi-quantitative analysis. At the same time, the rest of the detection of tumor markers CA 153, CYFRA 211 content CEA, Then each of the four indicators alone or in various combinations were detection effectiveness evaluation. Results Ki-67 expression and CYFRA 211, CEA levels In malignant group were higher than benign group, the difference was significant difference （P〈0.05）. In the evaluation of effectiveness, When four project testing pleural and peritoneal effusions alone, Sensitivity and negative predictive value is the lowest CA 153, specificity is the lowest CYFRA 211, positive predictive value is the lowest CEA. When pairwise combinations of the highest sensitivity in the detection is CYFRA 211 and Ki-67, and up to 98.0%, but the specificity is low. Ki-67 and CA 153 in specificity despite the highest, to 76.4%, but the sensitivity is lowest at 88.3%. In the three combinations, each combination may increase the sensitivity to 90.0%, but the specificity than single test or the results of pairwise binding assays were low. The sensitivity of the above four indicators together when combined detection of i 00.0%, while specificity was detected in several ways to the

关 键 词：KI-67 胸腹水 液基薄层细胞制片 免疫细胞化学染色 肿瘤标志物 

分 类 号：R730.43[医药卫生—肿瘤]