床旁联合检测ROS和FH在鉴别良恶性胸腹水样本中的临床价值  

Clinical value of combined detection of reactive oxygen species and cell free ferrous protoporphyrin in differentiating benign from malignant pleuroperitoneal fluid by point-of-care-testing

作　　者：郭睿[1] 赵世平 张娜[1] 杨军[1] GUO Rui;ZHAO Shiping;ZHANG Na;YANG Jun(Department of Pathology,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院病理科,西安710004

出　　处：《山西医科大学学报》2022年第3期360-363,共4页Journal of Shanxi Medical University

基　　金：国家自然科学基金项目(82102726)。

摘　　要：目的 研究床旁检测活性氧(reactive oxygen species, ROS)和细胞游离亚铁原卟啉(cell free ferrous protoporphyrin, FH)在鉴别良恶性胸腹水中的临床意义。方法 收集胸腹水样本196例,所有样本由有资质的细胞病理学医生通过细胞蜡块和常规细胞涂片进行检查和细胞病理学诊断。同时,采用ROS和FH染色检测ROS和FH在上述样本中的阳性表达。最后,评估ROS和FH联合检测作为筛选良恶性胸腹水的分子靶标的敏感性、特异性、准确率、阳性预测值和阴性预测值。结果 细胞病理学检查发现,在196例胸腹水样本中,恶性肿瘤患者样本67例,非恶性肿瘤患者样本129例。ROS和FH联合染色发现在196例胸腹水样本中,ROS阳性者82例,FH阳性者171例,ROS和FH双阳性者82例。以ROS、FH和ROS+FH作为诊断指标,其敏感性分别为50.75%,89.55%和89.55%;特异性分别为62.79%,13.95%和12.40%;阳性预测值分别为41.46%,35.09%和34.68%;准确率分别为58.67%,39.80%和38.78%;阴性预测值分别为71.05%,72.00%和69.57%。结论 ROS和FH联合染色的阴性预测值比较高,可作为一种新的快速筛查方法用于良恶性胸腹水的鉴别。Objective To investigate the clinical significance of combined detection of reactive oxygen species(ROS) and cell free ferrous protoporphyrin(FH) in differentiating benign from malignant pleuroperitoneal fluid by point-of-care-testing(POCT). Methods A total of 196 cases of pleuroperitoneal fluid samples were collected. All samples were examined and diagnosed by credential cytopathologist using cell block(CB) and conventional cytological smear(CS) methods. At the same time, ROS and FH in the above specimens were detected by ROS and FH staining. Finally, sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) of ROS,FH and their combination in rapid-screening pleuroperitoneal fluid specimens were calculated. Results The results showed that there were 67 cases of malignant tumor and 129 cases of non-malignant tumor in 196 cases of pleuroperitoneal fluid samples. The ROS+FH staining showed that 82 cases were positive for ROS, and 171 cases were positive for FH, and 82 cases were double positive for ROS+FH in 196 cases of pleuroperitoneal fluid samples. The sensitivity of ROS, FH and ROS+FH staining was 50.75%, 89.55% and 89.55%, respectively;the specificity of ROS, FH and ROS+FH staining was 62.79%, 13.95% and 12.40%;the positive predictive values of ROS, FH and ROS+FH staining were 41.46%, 35.09% and 34.68%;the accuracy rates of ROS, FH and ROS+FH staining were 58.67%, 39.80% and 38.78%;and the negative predictive values of ROS, FH and ROS+FH staining were 71.05%, 72.00% and 69.57%, respectively. Conclusion Based on the high negative predictive value, the combined staining of ROS and FH could be used as a new rapid-screening approach for differentiating benign from malignant pleuroperitoneal fluid samples.

关 键 词：恶性肿瘤 活性氧 细胞游离亚铁原卟啉 胸腹水 床旁诊断 

分 类 号：R446[医药卫生—诊断学]