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目的探讨脱落细胞DNA倍体分析联合核仁组成区嗜银蛋白(AgNOR)染色检查对恶性胸腔积液的诊断价值。方法应用流式细胞术(FCM)和AgNOR染色技术和对72例胸腔积液患者(良性积液30例,恶性积液42例)胸液中的脱落细胞进行DNA倍体分析和AgNOR染色检查,比较两组的检测结果。结果恶性组中DNA异倍体阳性率为78.6%,良性组的阳性率为6.7%。恶性组癌细胞内AgNOR颗粒数为(5.36±0.75),良性组为(1.42±0.41),以细胞内AgNOR颗粒数>3.86为阳性,恶性组AgNOR阳性率为85.7%,良性组阳性率为13%。两项指标良恶性组比较差异均有统计学意义(P<0.05)。两者联合(并联)检测,敏感度高于单一指标检测敏感度。结论脱落细胞DNA倍体联合AgNOR倍体检查可提高恶性胸腔积液诊断的敏感度。
Objective To investigate the diagnostic value of exfoliated cells DNA ploidy combined with nucleolar organizer region AgNOR staining in malignant pleural effusion. Methods Flow cytometry (FCM) and AgNOR staining were used to detect the exfoliated cells in pleural effusion of 72 patients with pleural effusion (benign effusion 30 cases, malignant effusion 42 cases) by DNA ploidy analysis and AgNOR staining. Compare the test results of two groups. Results The positive rate of DNA aneuploidy was 78.6% in malignant group and 6.7% in benign group. The number of AgNOR particles in the malignant group was (5.36 ± 0.75) and in the benign group was (1.42 ± 0.41), and the number of AgNOR particles was> 3.86 in the malignant group. The positive rate of AgNOR in the malignant group was 85.7% and the positive rate in the benign group was 13 %. The two indicators of benign and malignant groups were statistically significant differences (P <0.05). The combination of the two (parallel) test, the sensitivity is higher than a single index detection sensitivity. Conclusion Exfoliated cells DNA ploidy combined with AgNOR ploidy can improve the sensitivity of the diagnosis of malignant pleural effusion.