胸腹水高荧光细胞筛查恶性积液价值研究

摘要

To study the value of high-fluorescent cell for the screening of malignant hydrothorax or ascites. The clinical diagnosis results and hydrothorax or ascites specimens of 400 outpatients registered from January to December in 2014 were collected, and high-fluorescent cells were counted with Sysmex XE-5000 blood cell analyzer, and then stained for microscopy. Receiver operating characteristic (ROC) curve was used to explore the sensitivity, speci-ficity, positive likelihood ratio and negative likelihood ratio of high-fluorescent cell for screening malignant hydrothorax or ascites. The numbers of high-fluorescent cells of the cancer patients were significantly higher than those of the non-cancer patients, with Z equal to -7.372 and P less than 0.05. The values of the area under curve (AUC), sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 0.801, 70.67%, 84.31%, 4.50 and 0.35 respective-ly. Detection of high-fluorescent may be used to screen malignant hydrothorax or ascites, and further exami-nation and follow-up have to be performed in case the number of high-fluorescent cells in the hydrothorax or ascites is not less than 68.%目的：研究胸腹水高荧光细胞筛查恶性积液价值。方法：选取2014年1月至12月住院、门诊患者400例，收集临床诊断结果及胸腹水标本，选用Sysmex XE－5000血细胞分析仪检测高荧光细胞数并涂片染色镜检，运用受试者工作特征（receiver operating characteristic，ROC）曲线，分析研究胸腹水高荧光细胞筛查恶性积液的灵敏度、特异性、阳性似然比及阴性似然比，探讨高荧光细胞对恶性积液的诊断价值。结果：恶性肿瘤患者组高荧光细胞数明显高于非恶性肿瘤患者组（Z=－7.372，P<0.05），高荧光细胞数曲线下面积（area under curve，AUC）为0.801，灵敏度70.67%，特异性84.31%，阳性似然比4.50，阴性似然比0.35。结论：检测胸腹水高荧光细胞可用于恶性积液的筛查，当胸腹水标本高荧光细胞数临界值（cut－off值）≥68时，应进一步检查并跟踪随访。