薄层液基细胞学联合细胞DNA定量分析技术在恶性胸腔积液诊断中的应用价值

Application of thin-cytological test combined with DNA-image cytometry in the diagnose of malignant pleural effusion

目的探讨薄层液基细胞学(TCT)和DNA定量分析技术(DNA-ICM)联合诊断在恶性胸腔积液中的应用价值。方法收集678例伴有胸腔积液的住院患者标本,其中269例恶性胸腔积液标本作为试验组,另外409例良性胸腔积液标本作为对照组,标本离心后分别采用TCT和DNA-ICM进行检测。结果 TCT检查的灵敏度高于DNA-ICM分析,但特异度低于DNA-ICM分析。TCT在恶性胸腔积液诊断中的灵敏度为79.6%、特异度为84.8%,DNA-ICM分别为56.5%、95.1%,灵敏度差异有统计学意义(P<0.01);而TCT与DNA-ICM联合诊断的灵敏度为90.0%,特异度为89.5%,差异有统计学意义(P<0.01)。结论 TCT和DNA-ICM联合诊断可提高恶性胸腔积液的检出率,减少漏诊,在恶性胸腔积液的诊断中有重要的应用价值。

Objective To investigate the value of thin-cytological test (TCT) combined with DNA-image cytometry (DNA-ICM) in the diagnosis of malignant pleural effusion. Methods A total of 678 cases of hospitalized patients with pleural effusion were collected,269 cases of malignant pleural effusion were used as the experimental group,and 409 cases of benign pleural effusion were used as the control group.TCT and DNA-ICM were used to detect the samples after centrifugation. Results The sensitivity of TCT was higher than that of DNA-ICM analysis,while the specificity was lower.The sensitivity,specificity of TCT and DNA-ICM in the diagnosis of malignant pleural effusion were 79.6%,84.8% and 56.5%,95.1%,respectively.The difference of sensitivity was significant ( P <0.01). The sensitivity and specificity of combined diagnosis of TCT and DNA-ICM were 90.0% and 89.5%.The difference was statistically significant ( P < 0.01). Conclusion The combined diagnosis of TCT and DNA-ICM can improve the detection rate of malignant pleural effusion and reduce missed diagnosis.It has important application value in the diagnosis of malignant pleural effusion.