脱落细胞涂片、DNA图像倍体分析和细胞块及其联合试验对恶性胸腔积液的诊断价值

Values of exfoliated cell smear,DNA ploidy analysis,cell block and their combined detection in diagnosis of malignant pleural effusion

目的:研究脱落细胞涂片、DNA图像倍体分析、细胞块及其联合检测对恶性胸腔积液的诊断价值,为恶性胸腔积液的诊断及后续治疗提供依据。方法:对300例胸腔积液标本进行DNA图像倍体分析判定胸腔积液的良恶性,离心细胞沉淀进行涂片,并制作细胞块,采用免疫组织化学法判定恶性胸水的来源部位,比较3种方法单独和联合应用诊断胸腔积液的敏感度和特异度。结果:脱落细胞涂片、DNA图像倍体分析和细胞块诊断恶性胸腔积液的敏感度分别为83.13%、84.44%和79.52%,特异度分别为82.95%、86.64%和83.87%;采用平行试验诊断恶性胸腔积液的敏感度为98.79%;系列试验诊断恶性胸腔积液的特异度为99.54%。结论:3种方法联合应用较单独应用可以明显提高恶性胸腔积液的临床诊断效果。

Objective:To study the values of exfoliated cell smear,DNA ploidy analysis,cell block and their combined detection in the diagnosis of malignant pleural effusion,and to provide the evidence for the diagnosis and treatment of malignant pleural effusion.Methods:A total of 300 cases of pleural effusion specimens were analyzed by DNA ploidy analysis to judge the benign and malignant pleural effusion;the centrifuged cell pellet was used for smear,the cell block was made,and the source of malignant pleural effusion was judged by immunohistochemistry method.The sensitivities and specificities of three methods and their combined detection in the diagnosis of malignant pleural effusion were compared.Results:The sensitivities of exfoliated cell smears,DNA ploidy analysis and cell block in the diagnosis of malignant pleural effusion were 83.13%,84.44%,and 79.52%,respectively;the specificities were 82.95%,86.64%,and 83.87%,respectively;the sensitivity of parallel test in the diagnosis of malignant pleural effusion was 98.79%;the specificity of serial test in the diagnosis of malignant pleural effusion was 99.54%.Conclusion:The combined detection of three methods can significantly improve the clinical diagnotic effect of malignant pleural effusion compared with single detection of three methods.