腹水DNA含量测定对良、恶性腹水的鉴别诊断价值

Differential diagnostic significance of detecting DNA ploidy in benign and malignant ascites

目的 研究腹水DNA倍体对良、恶性腹水的鉴别诊断价值。方法 运用流式细胞术 (FCM )检测腹水的DNA指数 (DI) ,S期细胞百分比 (SPF) ,细胞增殖指数 (PI) ;采用化学发光分析法 ,检测腹水的CEA、CA19 9;腹水离心沉淀作细胞学检查。结果 恶性腹水组的DI、SPF、PI均高于良性腹水组 (P <0 0 5 ) ,FCM法诊断恶性腹水的敏感性和特异性分别为 91 7%和 92 3%。细胞学、CEA、CA19 9诊断恶性腹水的敏感性分别为 41 7%、41 7%、5 0 % ,特异性为10 0 %、76 9%、84 6 % ,FCM联合CEA或CA19 9检测 ,敏感性为 95 2 %及 95 8% ,特异性为 71%及 78 1%。结论 腹水DNA含量测定诊断恶性腹水是一有效而敏感的方法 ,但存在一定的局限性 ;FCM联合CEA或CA19 9检测可提高诊断恶性腹水的敏感性。

Objective To study significance of DNA ploidy content in benign and malignant ascites in the differential diagnosis. Methods The DI,SPF,PI in ascites were detected by flow cytometry(FCM); the CEA,CA19 9 were measured by chemiluminescence immunoassay and cytological examination was performed after centrifugal deposition. Results DI,SPF,PI in the group of malignant ascites were higher than those of benign ascites ( P <0 05). The sensitivity and specificity were 91 7%,92 3% respectively in the diagnosis of malignant ascites by FCM, and the sensitivity was 41 7%,41 7%,50% and its specificity was 100%,76 9%,84 6% respectively in the diagnosis of malignant ascites by cytometry、CEA and CA19 9,FCM together with CEA or CA19 9 the sensitivity was 95 2% or 95 8%, and specificity was 71% or 78 1%. Conclusion It is effective and sensitive to diagnose malignant ascites by the measurement of DNA in ascites, but it has some limitation. FCM and CEA or CA19 9 can improve the sensitivity in the diagnosis of malignant ascites.