Metintaş M, Ozdemir N, Solak M, Artan S, Ozdemir M, Başaran N, Ekici M, Erginel S
Department of Chest Diseases, Anadolu University Medical Faculty, Meşelik, Eskişehir, Turkey.
Respiration. 1994;61(6):330-5. doi: 10.1159/000196364.
Various laboratory methods are being used to acquire diagnosis in pleural effusions. However, about 20% of the effusions cannot be diagnosed reliably. Cytogenetic analysis in pleural effusion is not used routinely, although many numerical and/or structural chromosome abnormalities have been observed in malignant pleural effusions. In this study, a total of the 61 pleural effusion samples, 34 malignant which included 19 diffuse pleural malignant mesothelioma, 15 metastatic malignant pleural effusions and 27 benign, were analyzed by direct chromosome analysis method. To the findings obtained in the study, 85.3% (29/34) of the 34 patients with malignant pleural effusion had numerical and/or structural abnormalities, and 3 of them had no mitosis. The patients who had benign pleural effusion indicated no numerical and/or structural abnormalities. We have concluded that if a pleural effusion cannot be reliably differentiated by the usual laboratory methods and especially malignancy is strongly suspected, cytogenetic analysis can be used to differentiate malignant effusions from benign effusions with a small rate of error, and also it can indicate that more invasive diagnostic procedures are necessary.
目前有多种实验室方法用于诊断胸腔积液。然而,约20%的胸腔积液无法得到可靠诊断。虽然在恶性胸腔积液中已观察到许多染色体数目和/或结构异常,但胸腔积液的细胞遗传学分析并非常规使用。在本研究中,采用直接染色体分析方法对总共61份胸腔积液样本进行了分析,其中34份为恶性,包括19例弥漫性胸膜恶性间皮瘤、15例转移性恶性胸腔积液,27份为良性。在该研究的结果中,34例恶性胸腔积液患者中有85.3%(29/34)存在染色体数目和/或结构异常,其中3例无有丝分裂现象。良性胸腔积液患者未显示染色体数目和/或结构异常。我们得出结论,如果胸腔积液无法通过常规实验室方法可靠鉴别,尤其是强烈怀疑为恶性时,细胞遗传学分析可用于以较低错误率区分恶性积液和良性积液,并且还可表明需要更具侵入性的诊断程序。