流式细胞术联合全自动细胞图像DNA指数分析鉴别胸腹腔积液性质的临床价值

The combination of flow cytometry and automated cell image analyzer in determining the nature of ascites and pleural effusion nature

目的探讨流式细胞术（FCM）和全自动细胞图像（AICM）DNA指数分析在胸腹腔积液性质鉴别中的应用价值。方法横断面调查。收集2013年8月至2014年6月解放军总医院的住院患者的新鲜胸腹腔积液样本203份，分别采用FCM和AICM对其中沉渣细胞进行DNA分析，通过异倍体细胞的数量和比例鉴别胸腹腔积液性质。通过四格表的敏感度、特异度和受试者工作曲线（ROC曲线）结合比较样本脱落细胞涂片镜检所得突出二者检测DNA倍体含量在胸腹腔积液性质鉴别中的优越性。结果FCM的敏感度、特异度和准确度分别为78．6％、80．0％和79．2％，AICM方法的敏感度、特异度和准确度分别为83．5％、78．6％和81．3％，二者联合后检测的敏感度、特异度和准备度分别为92．2％、88．3％和89．6％。结论FCM和AICM仪二者结合起来在胸腹腔积液性质的辅助诊断上与常规细胞学检测结果比较敏感度差异有统计学意义，二者结合可辅助临床用于胸腹腔积液性质的鉴别而诊断疾病。

Objective To explore the clinical value of flow cytometry（ FCM ） and DNA automated cell image analyzer （AICM） in determine the character of ascites and pleural effusion. Methods This was a cross-sectional study. 203 ascites and pleural effusionsamples were random selected from PLA hospital inpatients between August 2013 to June 2014 . The DNA content of sediment cells were detectedthrough the FCM and AICM respectively benign and malignant disease were differentiated according the counts and proportion of aneuploid cells. The sensitivity, specificitywere calculated byROC curves. Results The sensitivity, specificity and aceuracy of flow eytometry cell in detectingtumor cells were 78.6% , 80.0% and 79, 2% % , while the sensitivity, specificity and accuracy of image analyzer were 83.5% ,78.6% and 81. 3% respectively. When FCM and AICMwere combined , the sensitivity, specificity and accuracyincreased to 92,2% , 86.3% and 89.6%. Conclusions Compared toconventional cytology test, the sensitivity and specificity were significantly high when the two methods were combined . Therefore, the combination method can be used to assist in clinical identification of the nature of ascites and pleural effusion and to help the diagnosis of disease. （Chin J Lab Med,2015,38：183-185）