除细胞学检测外，DNA分析在恶性胸腔积液诊断中的价值。

Value of DNA analysis in addition to cytological testing in the diagnosis of malignant pleural effusions.

作者信息

Rodríguez de Castro F, Molero T, Acosta O, Julià-Serdà G, Caminero J, Cabrera P, Carrillo T

机构信息

Section of Pulmonary Diseases, Hospital Universitario Ntra. Sra. del Pino, Facultad de Ciencias de la Salud, Universidad de Las Palmas, Gran Canaria, Spain.

出版信息

Thorax. 1994 Jul;49(7):692-4. doi: 10.1136/thx.49.7.692.

DOI:10.1136/thx.49.7.692

PMID:8066565

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC475059/

Abstract

BACKGROUND

Aneuploidy appears to be a highly specific marker for cancer, and measurement of cellular DNA content by flow cytometry is rapid and reliable. This study was undertaken to determine if the addition of DNA analysis improved the sensitivity of cytological diagnosis of malignancy in pleural fluid.

METHODS

Pleural effusions from 92 patients were studied by cytological examination and flow cytometry.

RESULTS

In 41 patients the final diagnosis was malignancy, there were 40 cases of benign effusions including 22 with pleural tuberculosis, and in the remaining 11 patients with biopsy proven cancer the presence of malignant cells was not found by cytological and histological means in the pleural fluid. Aneuploidy and cytological malignancy were found in 14 samples. There were seven cases with abnormal flow cytometry and negative cytological results. In 12 patients the cytological test results were positive but DNA analysis was normal. Thirty six samples of fluid were both diploid and cytologically negative. Of the 22 tuberculous effusions seven contained aneuploid cells. The sensitivity of DNA and cytological analysis was 51.2% and 63.4%, respectively. The specificity of DNA analysis was 74.5%.

CONCLUSIONS

DNA analysis of cells in malignant pleural effusions is both less sensitive and specific than the cytological diagnosis. Flow cytometric analysis is not recommended for routine use in the diagnosis of pleural effusions.

摘要

背景

非整倍体似乎是癌症的一种高度特异性标志物，通过流式细胞术测量细胞DNA含量快速且可靠。本研究旨在确定DNA分析的加入是否能提高胸腔积液恶性病变细胞学诊断的敏感性。

方法

对92例患者的胸腔积液进行了细胞学检查和流式细胞术研究。

结果

41例患者最终诊断为恶性肿瘤，40例为良性积液，其中22例为结核性胸膜炎，其余11例经活检证实为癌症，但胸腔积液的细胞学和组织学检查均未发现恶性细胞。14份样本中发现了非整倍体和细胞学恶性病变。7例流式细胞术异常但细胞学结果为阴性。12例患者细胞学检查结果为阳性但DNA分析正常。36份积液样本为二倍体且细胞学检查为阴性。22例结核性积液中有7例含有非整倍体细胞。DNA分析和细胞学分析的敏感性分别为51.2%和63.4%。DNA分析的特异性为74.5%。