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目的:评价脱落细胞学、DNA异倍体、肿瘤标志物检查联合诊断恶性胸腹水的应用价值。方法:贝克曼公司RS-6500流式细胞分析仪,观察DNA异倍体,以DNA异倍体≥10%作为阳性标准;涂片染色,镜下观察细胞形态特征;肿瘤标志物检查使用Combas 6000电化学发光仪测定。结果:39例恶性肿瘤,DNA异倍体分析有21例阳性,阳性率53.9%,70例良性肿瘤仅1例阳性,阳性率1.4%;细胞学检查,39例恶性胸腹水以找到癌细胞为阳性,阳性16例,阳性率41.0%,70例良性胸腹水中,未找到癌细胞;肿瘤标志物(SF、CEA、NSE、CA-125)检查,恶性阳性率为74.4%,61.5%,64.4%,72.0%,良性阳性率为15.8%,21.4%,12.5%,5.6%,差异有统计学意义(P<0.01),4项联合检测,以任意一项阳性指标作为阳性判断,可将敏感度提高到92.3%。细胞学、DNA异倍体与肿瘤标志物联合检测,其联合灵敏度为87.0%,联合特异度为77.7%,灵敏度明显提高。结论:脱落细胞学、DNA异倍体、肿瘤标志物联合检测,可大大提高恶性胸腹水的诊断阳性率。
Objective: To evaluate the diagnostic value of exfoliated cytology, DNA aneuploidy and tumor marker in the diagnosis of malignant pleural effusion. METHODS: Beckman RS-6500 flow cytometer was used to observe the DNA aneuploidy with DNA aneuploidy≥10% as the positive standard. The smear staining and morphological features were observed microscopically. Combat 6000 Electrochemical Luminometer Determination. Results: Of the 39 malignant tumors, 21 were positive for DNA aneuploidy, with a positive rate of 53.9%. Only 1 of 70 benign tumors was positive, with a positive rate of 1.4%. Cytology and 39 malignant pleural effusions were used to find cancer cells The positive rate of malignant tumor was 74.4%, 61.5%, 64.4 (P <0.05), and the positive rate was 74.4%, and the positive rate was 41.0% in 70 cases of benign pleural effusion. %, 72.0%. The positive rate was 15.8%, 21.4%, 12.5% and 5.6%, respectively. There was significant difference between the two groups (P <0.01) Degree increased to 92.3%. Cytology, DNA aneuploidy and tumor markers combined detection of the combined sensitivity of 87.0%, the joint specificity of 77.7%, the sensitivity was significantly improved. Conclusion: Exfoliative cytology, DNA aneuploidy, combined detection of tumor markers, can greatly improve the diagnostic rate of malignant pleural effusion.