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目的 探讨端粒酶活性检测在良恶性胸水中的诊断价值。方法 采用TRAP PCR ELISA定量及TRAP PCR银染定性法 ,对 32例恶性胸水和 2 9例良性胸水样本进行端粒酶活性分析 ,并将结果与胸水细胞学诊断结果进行比较。结果 端粒酶定性和定量结果均显示癌性胸水样本中端粒酶活性水平显著高于良性胸水样本 (P <0 .0 5 )。端粒酶鉴别良恶性胸水的敏感性为 71.8% (2 3/32 ) ,特异性为 89.7% (3/2 9) ;细胞学检查的敏感性为 6 8.8% (2 2 /32 ) ,特异性为 10 0 % (0 /2 9) ;两者无显著性差异 (P <0 .0 5 )。在 2 2例细胞学阳性胸水样本有 19例端粒酶阳性 ,2例细胞学可疑胸水标本 1例端粒酶阳性 ,10例细胞学阴性胸水样本有 3例端粒酶阳性。端粒酶检测和细胞学检查的符合率为 82 6 % ,若 2者联合应用 ,胸水诊断的敏感性可提至84 4 %。结论 端粒酶活性检测 ,可能在良恶性胸水的鉴别诊断方面 ,有重要的辅助诊断价值
Objective To investigate the diagnostic value of telomerase activity in benign and malignant hydrothorax. Methods TRAP PCR ELISA and TRAP PCR silver staining were used to analyze the telomerase activity in 32 cases of malignant pleural effusion and 29 cases of benign pleural effusion. The results were compared with those of cytological diagnosis of pleural effusion. Results The qualitative and quantitative results of telomerase showed that the level of telomerase activity in cancerous pleural effusion samples was significantly higher than that in benign pleural effusion samples (P <0.05). The sensitivity and specificity of telomerase in distinguishing benign and malignant pleural effusions were 71.8% (2 3/32) and 89.7% (3/2 9), respectively. The sensitivity of cytology was 68.8% (2/32) Sex was 10% (0/29); there was no significant difference between the two (P <0.05). Twenty-nine cytology-positive pleural effusion samples were positive for telomerase in 19 samples, 1 telomerase positive in 2 cytologically suspected pleural effusion samples, and 3 telomerase positive in 10 samples of cytology-negative pleural effusion. The coincidence rate of telomerase and cytology was 82.6%. If combined, the sensitivity of pleural effusion diagnosis could reach 84.4%. Conclusion The detection of telomerase activity may have important diagnostic value in the differential diagnosis of benign and malignant hydrothorax