腹水超短期DNA倍体分析联合肿瘤标志物在良恶性腹水诊断中的应用  

The application of ultra short-time DNA ploidy analysis of ascites and tumor markers in the diagnosis of benign and malignant ascites

作　　者：朱晚林[1] 叶淑芳[1] 胡晓蕾[1] 叶斌[1] 吴晓[1] 

机构地区：[1]丽水市中心医院消化内科,浙江丽水323000

出　　处：《中国卫生检验杂志》2016年第13期1872-1874,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江丽水市科技计划项目(2012JYZB96)

摘　　要：目的探讨腹水DNA倍体分析联合肿瘤标志物在良恶性腹水鉴别诊断中的意义。方法选102例腹水患者为研究对象,其中恶性腹水组52例,良性腹水组50例。穿刺腹水取得标本后在30 min内分别检测其腹水DNA倍体,发现异倍体为阳性,同时查AFP、CEA、CA125,超过参考值上限为阳性,送病理科检测细胞学,发现癌细胞为阳性。结果在诊断良性、恶性腹水上DNA倍体分析的敏感度和特异度分别为78.85%和88.00%,而AFP、CEA、CA125的敏感度和特异度分别为26.92%和98.00%、63.46%和94.00%、78.85%和38.00%。腹水细胞学诊断的敏感度为50.00%,特异度为100.00%。DNA倍体分析联合CEA、AFP检测其敏感度和特异度为96.15%和100.00%。结论 CA125在良性、恶性腹水的鉴别中意义不大,腹水DNA倍体分析的敏感性较CEA、AFP高,DNA倍体分析联合CEA、AFP检测可显著提高良性、恶性腹水诊断的敏感性和特异性。Objective To investigate the differential diagnosis significance of the DNA ploidy analysis in ascites combined with tumor markers in benign and malignant ascites. Methods A total of 102 patients with ascites were selected as subjects,including 52 cases of malignant ascites and 50 cases of benign ascites. Ascites punctured samples were obtained for the detection of ascites DNA ploidy within 30 min,and aneuploidy was positive. At the same time,AFP,CEA,CA125 were detected,exceeding the reference value upper limit was considered as positive,which was sent to pathology department for cytological examination,with all the cancer cells positive. Results The sensitivity and specificity of DNA ploidy analysis in ascites were 78. 85%and 88. 00%,respectively,while the sensitivity and specificity of AFP,CEA and CA125 were 26. 92% and 98. 00%,63. 46% and 94. 00%,78. 85% and 38. 00%,respectively. The sensitivity and specificity of ascites cytology was 50. 00% and100. 00%. The sensitivity and specificity of DNA ploidy analysis combined with the CEA and AFP in ascites were 96. 15% and100. 00%,respectively. Conclusion CA125 in the identification of benign and malignant ascites is not significant,the sensitivity of DNA ploidy analysis of ascites was higher than CEA,AFP. DNA ploidy analysis combined with AFP,CEA detection can significantly improve the sensitivity and specificity of benign and malignant ascites diagnosis.

关 键 词：腹水 DNA倍体分析 肿瘤标志物 鉴别诊断 

分 类 号：R572.2[医药卫生—消化系统]