Dewald G, Dines D E, Weiland L H, Gordon H
N Engl J Med. 1976 Dec 30;295(27):1494-500. doi: 10.1056/NEJM197612302952702.
To determine whether chromosome analysis could facilitate the diagnosis of malignant pleural effusions, we examined chromosomes in effusions from 104 unselected patients. An effusion was regarded as malignant if at least three of 30 metaphase cells were hyperdiploid or contained a marker chromosome. Results were compared with standard cytologic diagnoses. All 22 benign effusions were diagnosed correctly by cytologic examination, but one nosed correctly by cytologic examination, but one (acute rheumatoid lung disease) was misclassified as positive by chromosome criteria. Of the 82 malignant effusions, 53 (65 per cent) were diagnosed correctly by cytologic tests, as compared with 58 (71 per cent) by chromosome analysis (P greater than 0.2). Among patients with malignant neoplasms, 13 had leukemia or lymphoma; only four of these (31 per cent) were diagnosed by cytologic tests as compared with 11 (85 per cent) by chromosome analysis (P less than 0.01). The combination of standard cytologic and chromosome analyses correctly identified 83 per cent of the neoplasms, a result significantly better than that with either technic alone (P less than 0.01).
为了确定染色体分析是否有助于恶性胸腔积液的诊断，我们检查了104例未经挑选患者胸腔积液中的染色体。如果30个中期细胞中至少有3个为超二倍体或含有标记染色体，则该胸腔积液被视为恶性。将结果与标准细胞学诊断进行比较。所有22例良性胸腔积液均通过细胞学检查正确诊断，但有1例（急性类风湿性肺病）细胞学检查诊断正确，但根据染色体标准被误分类为阳性。在82例恶性胸腔积液中，53例（65%）通过细胞学检查正确诊断，而通过染色体分析为58例（71%）（P>0.2）。在患有恶性肿瘤的患者中，13例患有白血病或淋巴瘤；其中只有4例（31%）通过细胞学检查诊断，而通过染色体分析为11例（85%）（P<0.01）。标准细胞学和染色体分析相结合正确识别了83%的肿瘤，这一结果明显优于单独使用任何一种技术（P<0.01）。
