DNA倍体分析联合AgNOR检查对恶性胸腔积液的诊断价值

Value of detection of DNA ploidy combined with AgNOR counting in diagnosis of malignant pleural effusions

目的探讨脱落细胞DNA倍体分析联合核仁组成区嗜银蛋白(AgNOR)染色检查对恶性胸腔积液的诊断价值。方法应用流式细胞术(FCM)和AgNOR染色技术和对72例胸腔积液患者(良性积液30例,恶性积液42例)胸液中的脱落细胞进行DNA倍体分析和AgNOR染色检查,比较两组的检测结果。结果恶性组中DNA异倍体阳性率为78.6%,良性组的阳性率为6.7%。恶性组癌细胞内AgNOR颗粒数为(5.36±0.75),良性组为(1.42±0.41),以细胞内AgNOR颗粒数>3.86为阳性,恶性组AgNOR阳性率为85.7%,良性组阳性率为13%。两项指标良恶性组比较差异均有统计学意义(P<0.05)。两者联合(并联)检测,敏感度高于单一指标检测敏感度。结论脱落细胞DNA倍体联合AgNOR倍体检查可提高恶性胸腔积液诊断的敏感度。

Objective To investigate the value of detection of DNA（deoxyribonucleic acid） ploidy and AgNOR（nucleolus organizer area argentophilic protein）counting in diagnosis of malignant pleural effusions.Methods Seventy two patients with pleural effusions（30 benign cases and 42 malignant cases）were examined for DNA ploidy analysis and AgNOR counting by flow cytometry（FCM）and AgNOR staining.The results in both groups were compared wo groups.Results The positive rate DNA heteroploid in malignant group was 78.6%,and that of benign group was 6.7%.The number AgNOR granules within cancer cells in malignant group was（5.36±0.75）and（1.42±0.41）for benign group,In case the number of AgNOR granules in the cell 3.86 was taken as positive,then the positive rate of AgNOR in malignant group was 85.7% and 13% in the benign group.Significant differences were observed between malignant and benign groups after comparison of the two indicators（P〈0.05）.The sensitivity of combined detection was higher than that of signal index detection.Conclusions Combined detection of exfoliated cell DNA ploidy and AgNOR counting could improve the sensitivity of the diagnosis of malignant pleural effusion.