DNA定量分析法联合癌胚抗原测定在良恶性胸水鉴别诊断中的应用

Diagnostic Value of DNA-image Cytometry and Carcinoembryonic Antigen Assay for Differential Diagnosis of Benign and Malignant Pleural Effusions

目的探讨细胞DNA定量分析法在恶性胸水诊断中的应用价值。方法 324例胸腔积液患者抽取胸水,巴氏染色行脱落细胞学检查,Feulgen染色行细胞DNA定量分析;同时进行胸水和血清癌胚抗原(CEA)测定。结果脱落细胞学检测良恶性胸水的敏感性61.27%,特异性94.5%,准确率79.94%;细胞DNA定量分析检测良恶性胸水的敏感性为95.07%,特异性为100%,准确率为97.84%;胸水CEA检测良恶性胸水的敏感性为66.9%,特异性为92.3%,准确率为81.17%;血清CEA检测良恶性胸水的敏感性为50%,特异性为84.62%,准确率为69.44%。结论脱落细胞学联合细胞DNA定量分析及CEA检测可提高良恶性胸水鉴别诊断的准确性。

Objective To explore the dingnostic value of DNA-image cytometry and carcinoembryonic antigen assay in differentiating malignant pleural effusions from benign ones. Methods 324 samples of pleural effusions were stained by Pap staining for cytology analysis, and with Feulgen method for detection of DNA-image cytometry. Chemiluminescence immune assay was used to detect CEA in both pleural effusions and serum. Results The sensitivity of the cytology analysis was 61.27% ,the specificity was 94.5% and the accuracy was 79.94%. The sensitivity of the DNA-image cytometry was 95.07% ,the specificity was 100% and the accuracy was 97.84%. The sensitivity of the CEA test in pleural effusions was 66.9% ,the specificity was 92.3% and the accuracy was 81.17%. The sensitivity of the CEA test in serum was 50% ,the specificity was 84.62% and the accuracy was 69.44%. Conclusion The combination of DNA image eytometry,CEA test for pleural effusions and cytology analysis is helpful in raising the accuracy of cytopathological diagnosis of benign or malignant pleural effusions.