EZH2、GLUT-1联合DNA-ICM检测在胸腔积液中鉴别良恶性间皮病变的价值

The value of EZH2 and GLUT-1 combined with DNA-ICM detection in the identification of benign and malignant mesothelial lesions in pleural effusion

目的探讨免疫细胞化学技术检测EZH2、GLUT-1联合细胞DNA定量分析(DNA image cytometry,DNA-ICM)在胸腔积液内间皮性病变诊断的临床价值。方法收集胸腔积液病例共50例,其中MM 30例,RMH 20例,行细胞块联合免疫细胞化学技术检测EZH2及GLUT-1的表达情况,以活检结果为对照,探讨本组抗体在胸腔积液中鉴别MM及RMH的意义,同时行Feulgen染色并DNA-ICM检测,比较免疫细胞化学技术、DNA-ICM及联合检测,诊断MM的灵敏度及特异度。结果1)联合检测EZH2、GLUT-1,对MM诊断的灵敏度为93%,特异度为86%,与单个抗体比较差异有统计学意义(P<0.05);2)联合应用免疫细胞化学技术及细胞DNA-ICM敏感度为97%,显著高于单一方法检测的灵敏度(P<0.05),特异度为75%,与单一方法比较没有统计学意义(P>0.05)。结论联合检测EZH2与GLUT-1,可作为胸腔积液内MM与RMH敏感性较强的鉴别诊断指标;结合细胞DNA-ICM技术能进一步提高二者鉴别诊断的灵敏度。

Objective To explore the clinical value of immunocytochemical detection of EZH2 and GLUT-1 combined with DNA image cytometry(DNA-ICM)in the diagnosis of mesothelial lesions in pleural effusion.Methods A total of 50 patients with pleural effusion were included in this study,of which 30 were malignant mesothelioma(MM)and 20 were reactive mesothelial hyperplasia(RMH).The expression of EZH2 and GLUT-1 was detected by cell block combined with immunocytochemistry,and the biopsy results were used as a control to explore the significance of these antibodies in distinguishing MM and RMH in pleural effusion.Meantime,Feulgen staining was performedfor DNA-ICM detection.The sensitivity and specificity of immunocytochemistry,DNA-ICM,and combined detection in the diagnosis of MM were further compared.Results 1.The combined detection of EZH2 and GLUT-1 had a sensitivity of 93%and a specificity of 86%for the diagnosis of MM,and the difference was statistically significant compared with a single antibody(P<0.05).2.The sensitivity of combined application of immunocytochemistry and cellular DNA-ICM was 97%,which was significantly higher than that of a single method(P<0.05),while the specificity was 75%,which was not statistically significant compared with a single method(P>0.05).Conclusion The combined detection of EZH2 and GLUT-1 can be used as a highly sensitive differential diagnosis index for MM and RMH in pleural effusion and the sensitivity of differential diagnosis can be further improved by combining cell DNA-ICM technology.