DNA含量分析和非白细胞细胞群CD44分子的检测在胸腔积液诊断和鉴别诊断中的价值

Diagnostic value of DNA content and CD44 in non-leukocyte cells in pleural effusion

[目的]探讨胸水脱落细胞的DNA含量分析和非白细胞细胞群CD44分子的检测在诊断和鉴别诊断良、恶性胸腔积液中的作用。[方法]选取各种胸腔积液标本121例,包括恶性胸腔积液标本65例,结核性胸腔积液24例,和其他良性胸腔积液32例(对照组)。应用流式细胞术分别测定各组标本内DNA异倍体的含量、处于G0/G1期细胞的百分比及胸水脱落细胞中非白细胞细胞群的CD44分子的表达,并对结果进行分析。[结果]恶性胸腔积液组中,异倍体检出率为76.9%(50/65),D I值为1.14±0.03,而结核性胸腔积液组和对照组均未检出异倍体。G0/G1含量分析中,对照组G0/G1含量为(95.77±2.30)%,PI(4.23±2.29)%;结核性胸腔积液组G0/G1含量高于对照组(P<0.05),为(98.53±0.77)%,PI为(1.2±0.81)%;而未检出异倍体恶性胸腔积液组(n=15),与对照组比较差异则无显著性意义(P>0.05),其G0/G1含量为(95.20±2.10)%,PI为(4.75±2.50)%。胸水脱落细胞中,中性粒细胞、淋巴细胞等白细胞群的CD44分子表达率均为100%。非白细胞细胞群中,对照组中CD44分子表达率为(25.02±12.20)%,恶性胸腔积液组表达率为(52.15±25.15)%,明显高于对照组(P<0.01),而结核胸腔积液组为(21.98±13.02)%,与对照组相比差异无显著性意义(P>0.05)。[结论]对胸腔积液脱落细胞进行DNA分析及检测非白细胞群CD44分子有助于诊断和鉴别诊断良、恶性及结核性胸腔积液。

[ Objective] This work is to evaluate the role of DNA content and CD44 in non -leukocyte cells in diagnosis of pleural effusions. [ Methods] One hundred and twenty - one patients with pleural effusion were divided into malignant pleural effusion group （ n = 65 ）, tubercular pleural effusion group （ n = 24） and control group （ n = 32）. DNA diploid, the percentage of G0/G1 in cell cycle and the expression of CD44 were examined by flow cytometry. [ Results] （ 1 ） In malignant pleural effusion group, aneuploidy was detected in 50 of 65 patients （76.9%） and DNA index （DI） were 1. 14 ±0.03, while the aneuploidy could not be seen in both tubercular pleural effusion and control groups. （2） In the analysis of the DNA cycle, the value of G0/G1 phase in tubereular pleural effusion group [ （98.53±0.77） % ,PI （ 1. 2 ±0.81 ） % ] was significantly higher than that in control group [ （95.77 ±2.30）% ,PI （4.23 ±2.29） % ], P 〈0.05. In addition, there was no difference between malignant pleural effusion group with no aneuploidy [ n = 15, （ 95.20 ± 2.10 ） %, PI （ 4.75 ± 2.50） % ] and control group. （ 3 ） Among the cells of pleural effusion, leukocytes showed 100% CD44 positive. For non -leukocyte cells, compared with control group [ （25.02 ± 12.20）% ], the positive percentage of CD44 in malignant pleural effusion group significantly increased [ （52.15 ± 25.15 ）% ], P 〈 0.01, while there was no difference between tubercular pleural effusion [ （21.98 ± 13.02）% ] and control groups（ P 〉 0.05）. [ Conclusion ] Detection of DNA content and CD44 in non - leukocyte cells would be helpful for diagnosis or differential diagnosis of benignant, malignant, or tubercular pleural effusions.