间皮细胞检测在胸腔积液诊断中的临床应用

Clinical application of pleural mesotheHal cell determination in the diagnosis of pleural effusion

目的探讨间皮细胞检测在胸腔积液诊断中的临床应用。方法对36例恶性胸腔积液患者（恶性组）和24例良性胸腔积液患者（良性组）胸腔积液进行间皮细胞检测，判定其在良、恶性胸腔积液中的诊断价值。结果恶性组未出现间皮细胞消失病例，间皮细胞所占百分比〈1％者1例（2．78％），1％-5％者1例（2．78％），〉5％者34例（94．44％）。良性组11例（45．83％）未发现问皮细胞，间皮细胞所占百分比〈1％者8例（33．33％），1％-5％者2例（8．33％），〉5％者3例（12．50％）。两组间皮细胞所占百分比比较差异有统计学意义（r=43．4069，P〈0．01）。良、恶性组间皮细胞所占百分比95％可信区间分别为0．28％-5．10％、5．13％-10．91％，两组可信区间没有相互重叠，因此以胸腔积液间皮细胞所占百分比〉5％作为鉴别良、恶性胸腔积液的标准，其敏感度为94．44％（34136）、特异度为87．50％（21／24）、准确度为91．67％（55^60）。结论间皮细胞所占百分比是一种简单、易行、经济、快捷诊断良、恶性胸腔积液的方法，具有较高的敏感度、特异度和准确度，在临床诊断中有一定的参考价值。

Objective To explore the clinical application of pleura] mesothelial cell （PMC） determination in the diagnosis of pleura[ effusion. Methods PMC of 36 patients with malignant pleural effusion （malignant group） and 24 patients with benign pleura] effusion （benign group） were counted to determine the clinical value of PMC in benign and malignant pleura] effusion. Results In malignant group, there was no case with PMC disappear, 1 case （2.78%） with the percentage of PMC between 0 and 1%,1 case（2.78% ） between 1% and 5%, 34 cases （94.44%） more than 5%. In benign group, there were 11 cases（45.83%） with PMC disappear, 8 cases （33.33%） with the percentage of PMC between 0 and 1%, 2 cases （8.33%） between 1% and 5%, 3 cases（ 12.50% ） more than 5%. The percentage of PMC between two groups had significant difference （ A~ =43.4069,P 〈0.01）. 95% confidence intervals of PMC in benign and malignant group respectively were 0.28% - 5.10% and 5.13% - 10.91% ,which did not overlap. The percentage of PMC more than 5% was defined as the diagnosis standard of identifying benign and malignant pleural effusion,the sensitivity of the diagnosis was 94.44%（34/36）,the specificity was 87.50%（21/24） and the accuracy was 91.67%（55/60）. Conclusions PMC determination is a kind of easy ,economical and fast way to diagnose benign and malignant pleural effusion with high sensitivity,specificity and accuracy. Therefore, it has reference value in clinical diagnosis.