支气管肺泡灌洗液与胸腔积液细胞学对良、恶性胸腔积液的诊断价值

Bronchoalveolar lavage fluid and pleural effusion cytol ogy indiagnosis of benign and malignant pleural effusion

目的 探讨支气管肺泡灌洗液 (BALF)与胸腔积液细胞学对良性与恶性胸腔积液的鉴别方法。方法 对 42例胸腔积液患者进行BALF与胸腔积液细胞学及 pH、乳酸脱氢酶 (LDH )、癌胚抗原 (CEA)检测对比分析。 结果 间质细胞、巨噬细胞计数在BALF和胸腔积液结核组低于肿瘤组 (P均 <0 .0 1) ;BALF与胸腔积液中发现肿瘤细胞分别为 0 .10 2± 0 .0 47和 0 .14 0± 0 .0 5 3 (P >0 .0 5 ) ,两者的 pH、LDH、CEA水平比较差异无显著性 (P 均 >0 .0 5 )。结论 BALF与胸腔积液间质细胞和巨噬细胞检测对良性与恶性胸腔积液有重要的诊断与鉴别诊断价值 ,pH、LDH、CEA水平异常升高对恶性胸水的早期诊断有临床意义。

Objective To investigate the va lu e of bronchoalveolar lavage fluid (BALF) and pleural effusion cytology in diagno sis and differentiatial diagnosis of benign and malignant pleural effusion. Methods The BALF and pleural effusion cytology and pH, LDH and CEA from 42 patients with pleural effusion were comparatively analyz ed. Results The Leydig cells and macrophage cou nt in BALF group and pleural effusion tuberculosis group were all lower than tho se in the tumor group (all P<0.01); the tumor cells in BALF and pleural effu sion were 0.102±0.047 and 0.140±0.053, respectively (P>0.05), there were n o statistically significant differences in comparison of pH, LDH, CEA in these t wo groups (all P>0.05). Conclusion BALF and Leydig cells of pleural effusion and macrophage are important in diagnosis and differential diagnosis of benign and malignant pleural effusion, the abnormal el evation of pH, LDH and CEA levels is of clinical significance in early diagnosis of malignant pleural effusion.