细胞DNA定量分析在鉴别良恶性胸腹水中的应用价值

摘要

目的：通过与液基细胞学( LBC)诊断比较,探讨细胞DNA定量分析技术( DNA-ICM)在良恶性胸腹水诊断中的应用价值。方法收集417例胸腹水标本,分别采用 LBC和DNA-ICM两种方法判定其良恶性,并将两种结果进行对比。结果417例胸腹水标本均经临床或病理诊断证实,213例为恶性,204例为良性。 DNA-ICM在胸腹水良恶性诊断中的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为89．7%、100%、94．7%、100%、90．3%；而 LBC 分别为63．4%、81．9%、72．4%、78．5%、68．2%；两者之间敏感度、特异度、准确度、阳性预测值、阴性预测值差异均有统计学意义(P<0．01)。结论 DNA-ICM在诊断胸腹水良恶性方面有较大应用价值,与LBC联合使用可提高胸腹水阳性检出率,降低漏诊率。%Objective To investigate the value of DNA image cytometry in thediagnose of benign and malignant pleuroperitoneal fluids by comparing with the liquid-based cytological results. Methods There were 417 cases in-volved in this study. Pap stain for cytology analysis and feulgen stain for DNA image cytometry were used to identify benign and malignant pleuroperitoneal fluids respectively,then compared the results of the two methods. Results Clinically or pathologically,213 were classified as malignant and the other 204 as benign. The sensitivity, specifici-ty,accuracy, positive predictive value and negative predictivevalue of DNA image cytometry were 89. 7%,100%, 94. 7%,100%,and 90. 3%,respectively. However,the sensitivity,specificity,accuracy, positive predictive value and negative predictive value of liquid-based cytology were 63. 4%, 81. 9%, 72. 4%, 78. 5%, and 68. 2%, re-spectively. There were significant differences in thesensitivity, specificity,accuracy, positive predictive value and negative predictivevalue. Conclusion DNA image cytometry has great application value in the diagnosis of benign and malignant pleuroperitoneal fluids, and can increase the positive rate, reduce misdiagnosed rate with liquid-based cytology.