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结直肠癌患者的自动白细胞黏附抑制试验

Automated leucocyte adherence inhibition testing in patients with colorectal cancer.

作者信息

McLeod D K, Isbister W H

机构信息

Department of Surgery, Wellington Clinical School of Medicine, New Zealand.

出版信息

Immunol Cell Biol. 1987 Oct;65 Pt 5:377-85. doi: 10.1038/icb.1987.43.

Abstract

This paper details our initial experiences with a semi-automated leucocyte adherence inhibition (SALAI) assay in patients with colorectal disease. Two assay systems were used. Leucocytes from blood donors and patients with different colorectal diagnoses were tested for sensitization to colorectal tumour extracts, and leucocytes from healthy blood donors were assayed with serum from blood donors or patients to determine whether the serum itself contained factors which would react with the non-sensitized leucocytes in the test system. The sensitivity of the SALAI assay using patients' leucocytes was 64%, and the specificity was 68%. Discriminant analysis did not affect the sensitivity of the assay for colorectal cancer (64%), although the specificity was increased for all patients except those with malignant disease other than colorectal cancer. The sensitivity of the SALAI assay using patients' serum was 50% but the specificity was 74%. Discriminant analysis increased the sensitivity of this assay to 80% but specificity was reduced to 61%. Thus, the SALAI assay with patients' serum, although potentially more advantageous than the assay using patients' leucocytes in the clinical setting, was less specific. Furthermore, samples from patients with early colorectal cancers were less reactive making the serum assay unsuitable for screening asymptomatic patients. The SALAI assay using patients' leucocytes, however, has a higher sensitivity than most reported variations of the assay but a slightly lower specificity. It is suggested that the SALAI assay is preferable to other methods for leucocyte adherence inhibition (LAI) testing.

摘要

本文详细介绍了我们在结直肠疾病患者中进行半自动白细胞黏附抑制(SALAI)试验的初步经验。使用了两种试验系统。对来自献血者和患有不同结直肠疾病诊断的患者的白细胞进行检测,以确定其对结直肠肿瘤提取物的致敏情况,并且使用来自献血者或患者的血清对健康献血者的白细胞进行检测,以确定血清本身是否含有会在测试系统中与未致敏白细胞发生反应的因子。使用患者白细胞的SALAI试验的敏感性为64%,特异性为68%。判别分析并未影响该试验对结直肠癌的敏感性(64%),尽管除结直肠癌以外的恶性疾病患者除外,所有患者的特异性均有所提高。使用患者血清的SALAI试验的敏感性为50%,但特异性为74%。判别分析将该试验的敏感性提高到80%,但特异性降至61%。因此,在临床环境中,使用患者血清的SALAI试验虽然可能比使用患者白细胞的试验更具优势,但特异性较低。此外,早期结直肠癌患者的样本反应性较低,使得血清试验不适用于筛查无症状患者。然而,使用患者白细胞的SALAI试验比大多数报道的该试验变体具有更高的敏感性,但特异性略低。建议SALAI试验比其他白细胞黏附抑制(LAI)测试方法更可取。

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