尿沉渣分析仪联合显微镜镜检检测浆膜腔积液诊断恶性肿瘤的比较

Comparison of urinary sediment analyzer and microscopy in the diagnosis of malignant tumor by serosal cavity effusion

目的研究尿沉渣分析仪联合显微镜镜检检测浆膜腔积液,用于诊断恶性肿瘤的临床意义和价值。方法抽选2015年3月—2017年3月浆膜腔积液细胞计数检测120例患者为研究对象,按照不同的检验方法分为3组,采用显微镜手工计数检测的为A组,采用尿沉渣分析仪检测的为B组,采用尿沉渣分析仪联合显微镜镜检的为C组;比较3组的检查结果。结果显微镜镜检结果:21.67%标本检出除白细胞外的有核细胞,确诊为恶性肿瘤患者为20例(76.92%);尿沉渣仪检测管型计数在5个/μl及以上的标本共18例,显微镜镜检阳性值、阴性值、特异度、灵敏度,低于尿沉渣仪检测,3组间差异有统计学意义(P<0.05);3种方法检测红细胞计数、有核细胞计数差异无统计学意义(P>0.05)。结论尿沉渣分析仪和显微镜镜检检测浆膜腔积液各具优缺点,尿沉渣分析仪检测操作简单,具有可重复性,与显微镜镜检联合应用能有效提高检测灵敏度和特异度,确定恶性肿瘤细胞,对临床疾病诊断具有重要意义。

ObjectiveTo study the clinical significance and value of the urinary sediment analyzer combined with microscopy in detecting serosal cavity effusion in the diagnosis of malignant tumors. MethodsOne hundred and twenty patients who had their cell count of serous cavity effusion detected between March 2015 and March 2017 were selected as subjects, who were divided into three groups according to the test methods the manual microscopic counting group （group A）, the urinary sediment analyzer detection group （group B）, and the urinary sediment analyzer combined with microscopic detection group （group C）. The results of detection were compared between the three groups. ResultsWith the microscopic detection, nucleated cells except white blood cells were detected in 21.67% of the specimens, and 20 cases（76.92%）were diagnosed with malignant tumor. According to the urinary sediment analyzer, there were eighteen specimens the cast count of which was 5/μl or above. The positive predictive value, negative predictive value, specificity and sensitivity of microscopic detection were lower than those of the urinary sediment analyzer. There was statistically significant difference between the three groups（P〈0.05）. However, there was no significant difference between the three methods in the detection of red blood cell count or nucleated cell count（P〉0.05）. ConclusionThe detection of serous cavity effusion with either the urinary sediment analyzer or a microscope has its strengths and weaknesses. The detection with a urinary sediment analyzer is user-friendly and repeatable. When combined with a microscope, this approach can effectively improve the detection sensitivity and specificity, identify malignant cells, and is of great significance for clinical diagnosis.