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目的:探讨液基细胞学结合端粒酶活性检测诊断浆膜腔积液良恶性细胞的应用价值。方法:收集201例(临床病理证实为97例恶性,104例良性)胸腹水标本,每例标本采用液基细胞技术制成薄层细胞片,做HE染色,用于细胞学检查;同时采用PCR-TRAP技术检测端粒酶活性。结果:细胞学检查对恶性胸腹水诊断的敏感度为81.4%(79/97),特异性为90.4%(94/104),端粒酶活性检测方法对恶性胸腹水诊断的敏感度为92.8(90/97),特异性为98.1%(102/104),将两种方法相结合,在恶性腹水中二者同时为阳性为74.2%(72/97),而在良性胸腹水中同时为阳性为0.0%(0/104),将两种方法相结合对恶性胸腹水的诊断敏感性为99.0%(96/97),特异度为100.0%(104/104)。结论:液基细胞学结合端粒酶活性检测分析用于胸腹水良性与恶性细胞的鉴别诊断较细胞学方法敏感,避免漏诊。
Objective: To investigate the value of liquid-based cytology combined with telomerase activity in the diagnosis of benign and malignant serous effusions. Methods: Totally 201 specimens of pleural effusion and ascites were collected from 201 cases (pathologically confirmed as malignant and 104 cases benign). Thin-sliced cells were prepared using liquid-based cytology in each specimen. HE staining was performed for cytological examination. TRAP assay for telomerase activity. Results: The sensitivity of cytology was 81.4% (79/97), specificity was 90.4% (94/104), and the sensitivity of telomerase activity detection in malignant pleural effusion was 92.8 90/97) with a specificity of 98.1% (102/104). The combination of the two methods was 74.2% (72/97) positive in malignant ascites and positive in both benign and pleural effusions Was 0.0% (0/104). The sensitivity of the combination of the two methods for the diagnosis of malignant pleural effusion was 99.0% (96/97) and the specificity was 100.0% (104/104). Conclusion: Liquid-based cytology combined with telomerase activity assay is more sensitive than cytology in the differential diagnosis of benign and malignant cells in pleural effusion and ascitic fluid, so as to avoid misdiagnosis.