良恶性胸腔积液细胞端粒酶活性的研究

Detection of telomerase activity in bengin and malignant pleural effusion cells

目的 研究胸水细胞端粒酶活性对良恶性胸水的鉴别价值。方法 采用TRAP -Hyb法直接检测并在去除胸水淋细胞后再检测胸水细胞端粒酶活性 ,将检测结果和临床诊断进行比较。结果 直接检测胸水细胞端粒酶活性显示 5 4例良性胸水有 4例阳性、3 3例恶性胸水有 2 6例阳性 (P <0 .0 1) ,去除胸水淋巴细胞后胸水细胞端粒酶活性显示良性组有 1例阳性、恶性组有 2 3例阳性 (P <0 .0 1)。去除胸水淋巴细胞前后胸水细胞端粒酶活性诊断效能分别如下 :诊断灵敏度 0 .788和 0 .697、特异度为 0 .92 6和 0 .982、阳性预示值 0 .867和 0 .95 8、阳性似然比 10 .63 6和 3 7.63 6。结论 胸水细胞端粒酶活性的检测有助于鉴别良恶性胸水 。

Objective To study the diagnostic value of telomerase activity in differentiating malignant from bengin pleural effusions.Methods Eighty-seven specimens of pleural effusion cells were examined for telo merase activity by TRAP(telo serase repeat amplification protocol)-Hyb(hybrid) method. The results of telomerase activity examined before and after doing away those lymphocytes separated from which were compared with the final clinical diagnosises.Results Telomerase activity was detected directlt in 4 of 54 specimens of bengin pleural effusion cells and 26 of 33 samples of malignant pleural effusion cells( P <0.01). Simultaneously, 1 of 54 specimens of bengin pleural effusion cells were found to possess telomerase activity and 23 of 33 samples of malignant pleural effusion cells showed positive enzymatic activity after doing away those lymphocytes( P <]0.01). The diagnostic efficiency of telomerase activity is respectively as following:sensitivity 0.788 and 0.697,specificity 0.926 and 0.982,positive predictive value0.01). The diagnostic efficiency of telomerase activity is respectively as following:sensitivity 0.788 and 0.697,specificity 0.926 and 0.982,positive predictive value 0.867 and 0.958,positive likelihood ratio 10.636 and 37.636.Conolusion The results indicate that the detection of telomerase activity in pleural effusions is beneficial to differentiate malignant from bengin pleural effusions, and the diagnostic efficiency of telomerase activity examined after doing away those lymphocytes is superior to which including lymphocytes.