马文,杜娟,张先明,王焰
MA Wen,DU Juan,ZHANG Xianming,WANG Yan

• 1:贵州医科大学附院呼吸内科
• 2:贵州医科大学附院中心试验室

摘要(Abstract)：

目的:探讨胸水脱落细胞DNA倍体分析及胸水癌胚抗原(CEA)与血清CEA比值测定对恶性胸腔积液的诊断价值。方法:41例恶性胸腔积液患者为试验组,84例良性胸腔积液患者为对照组,抽取2组患者胸水和血液,采用全自动细胞图像分析系统对胸水脱落细胞进行DNA倍体分析,用蛋白芯片-化学发光法检测血及胸水癌胚抗原水平,计算胸水CEA与血清CEA比值;比较2种方法单独应用或联合应用时诊断恶性胸腔积液的灵敏度、特异度及youden值。结果:试验组胸水脱落细胞DNA倍体分析阳性率和胸水CEA与血清CEA比值阳性率均高于对照组(P<0.05);胸水脱落细胞DNA倍体分析对恶性胸腔积液诊断灵敏度为85.37%、特异度为66.67%、youden指数0.52,胸水CEA与血清CEA比值对恶性胸腔积液诊断灵敏度为78.05%,特异度为77.38%,youden指数0.55,2种方法比较差异无统计学意义(P>0.05);2种方法联合诊断恶性胸腔积液的灵敏度为96.79%,特异度为92.46%,youden指数0.59。结论:胸水脱落细胞DNA倍体分析联合胸水CEA与血清CEA比值测定,对鉴别良、恶性胸腔积液具有更好的诊断价值。
Objective: To explore the diagnostic value of DNA ploidy analysis of hydrothorax shedding cells by automatic DNA image cytometry and the ratio of pleural fluid CEA to serum CEA in diagnosis of malignant pleural effusion. Methods: Forty-one cases of patients with malignant pleural effusions were enrolled in experimental group while 84 cases of patients with benign pleural effusion in control group. The serum and pleural fluid specimens were collected from two groups and DNA ploidy analysis of hydrothorax shedding cells was conducted by automatic DNA image cytometry. The levels of CEA were determined by protein chip-chemoluminescence and the ratio of pleural fluid CEA to serum CEA were calculated. Then,the sensitivity,specificity and youden's index were compared between two groups when single method or two methods combined were adopted. Results: The positive rates of DNA ploidy analysis of hydrothorax shedding cells and the ratio of pleural fluid CEA to serum CEA in experimental group were significantly higher than their counterparts in control group( P < 0. 05). The sensitivity of the DNA ploidy analysis of hydrothorax shedding cells in diagnosis of malignant pleural effusion was 85. 37%,the specificity was 66. 67%,and the youden's index was 0. 52. The sensitivity of the ratio of pleural fluid CEA to serum CEA in diagnosis of malignant pleural effusion was 78. 05%,the specificity was 77. 38%,and the youden's index was 0. 55. There was no statistical difference between the two methods( P > 0. 05). The sensitivity of the DNA ploidy analysis combined the CEA ratio of hydrothorax / blood was 66. 63%,the specificity was 92. 46%,and the youden's index was 0. 59.Conclusion: The DNA ploidy analysis of hydrothorax shedding cells combined the CEA ratio of hydrothorax / blood may have a better diagnostic value in distinguish benign pleural effusion from malignant pleural effusion.

关键词(KeyWords)： 胸水;脱落细胞;DNA;倍体分析;癌胚抗原
pleural fluid;shedding cells;DNA;ploidy analysis;carcinoembryonic antigen

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 马文,杜娟,张先明,王焰
MA Wen,DU Juan,ZHANG Xianming,WANG Yan

DOI: 10.19367/j.cnki.1000-2707.2016.02.024

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