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目的探讨免疫荧光法与 p5 3单链构象多态性分析检测胸水肿瘤细胞 ,在良、恶性胸水鉴别诊断中的价值 .方法 采用免疫荧光法、血卟啉荧光法、吖啶橙荧光法检测胸水肿瘤细胞 ;p5 3单链构象多态性分析技术检测 p5 3基因突变 .结果 应用免疫荧光法、血卟啉荧光法、吖啶橙荧光法 ,通过对 81例恶性胸水患者胸水肿瘤细胞的检测 ,其阳性检出率分别为 :88.9% ,91.4%和 86 .2 % ;对 183例良性胸水患者胸水肿瘤细胞的检测 ,其阳性检出率分别为 :0 .2 2 % ,0 .39%和 0 .79% .结论 吖啶橙荧光法针对的是肿瘤细胞中的核酸物质 ,在荧光显微镜下极易识别 ,色彩鲜艳并具有恶性肿瘤细胞形态的特征 .血卟啉荧光方法 ,比较稳定 ,形态完整 ,红细胞及白细胞不显示荧光 ,荧光清晰 ,易于鉴别 .免疫荧光法 ,针对的是细胞膜抗原 ,当抗原抗体结合后 ,在细胞膜上形成一种荧光环 ,加上肿瘤细胞的特殊形态 ,即可与正常细胞区别 ,从而对胸水中的肿瘤细胞作出精确的诊断 .用 p5 3单链构象多态性分析 ,检测胸水细胞 p5 3基因突变已成为可能 ,对良、恶性胸水的鉴别诊断具有重要的意义 ,并具有较好的应用前景 .
Objective To investigate the value of immunofluorescence and p53 single-strand conformation polymorphism analysis in the differential diagnosis of benign and malignant pleural effusions. Methods Immunofluoresence assay, hematoporphyrin fluorescence assay, acridine orange fluorescence method for the detection of pleural effusion Tumor cells; p53 single-strand conformation polymorphism analysis technique was used to detect p53 gene mutations. Results Immunofluorescence, hematoporphyrin fluorescence, and acridine orange fluorescence were used to detect pleural fluid tumor cells in 81 patients with malignant pleural effusion. The positive detection rates were: 88.9%, 91.4%, and 86.2%. The detection rate of thoracic water tumor cells in 183 patients with benign pleural effusion was 0.22%, 0.39%, respectively. 0 .79% . Conclusion Acridine orange fluorescence method is aimed at the nucleic acid substances in tumor cells, easily identified under a fluorescent microscope, bright and has the characteristics of malignant tumor cell morphology. Hematoporphyrin fluorescence method, relatively stable, morphology Complete, red blood cells and white blood cells do not show fluorescence, fluorescence is clear, easy to identify. Immunofluorescence method is aimed at cell membrane antigens, when the antigen and antibody are bound, a fluorescent ring is formed on the cell membrane, plus the tumor The special morphology of cells can be distinguished from normal cells, so as to make accurate diagnosis of tumor cells in the pleural effusion. Using the p53 single-strand conformation polymorphism analysis, it has become possible to detect p53 gene mutations in pleural effusion cells. The differential diagnosis of pleural effusion has important significance and has a good application prospect.