胸水脱落细胞增殖细胞核抗原检测在肺癌诊断中的应用价值

Detection of PCNA protein expression in exfoliated cells in pleural fluid and its significance in diagnosis of lung cancer

目的探讨胸水脱落细胞增殖细胞核抗原（PCNA）检测在肺癌诊断中的应用价值。方法收集48例肺癌、40例良性胸水疾病患者，采用S—P法检测胸水脱落细胞PCNA蛋白的表达，并与细胞学检查结果比较。结果PCNA蛋白检测诊断肺癌的特异性为71．20％，低于胸水脱落细胞学检测的91．34％（P〈0．05），敏感性为100％，高于胸水脱落细胞学检测的82．20％（P〈0．05）。肺癌及良性胸水脱落细胞PCNA表达阳性率分别为78．26％和32．34％。肺癌及良性胸水患者间脱落细胞PCNA表达差异有统计学意义（P〈0．05）。胸水脱落细胞PCNA表达强度随肺癌分级增加而升高（P〈0．05），与肺癌组织类型及分化程度无关。结论胸水脱落细胞PCNA蛋白检测在肺癌早期诊断、常规筛查以及术后复发监测中具有潜在的应用价值。

Objective To evaluate the significance of detection of proliferation cell nuclear antigen （PCNA） protein expression in exfoliated cells in pleural fluid for the diagnosis of lung cancer. Methods The exfoliated cells in pleural fluid were collected from 48 patients with lung cancer, 40 patients with benign diseases. Immunohistochem- ical method and the cytologic analysis were carried out simultaneously, and the 2 detection results were compared. Results PCNA from pleural fluid exfoliated cells had lower specificity （71.20%） than that of cytologic analysis （91.34 0% ） P 〈 0. 05 , but its sensitivity （ 100. 00% ） signifieandy higher than that of cytological examination （82. 20% ）P 〈 0. 01. The expression of PCNA protein in pleural fluid exfoliated cells from patients with lung cancer, and that in patients with diseases were 78.26% ,32. 34% respectively. The expression positive rate of PCNA protein in higher grade lung cancer was greater compared with that in lower grade cancer（P 〈 0. 05 ） ;but it was not related to differentiation and pathological type. Conclusion PCNA protein detection by immunohistochemical method has potential value for the early diagnosis, routine screening and postoperative monitoring of lung cancer.