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目的:通过对39例胸腹水和腹腔液标本及12例胃肠癌端粒酶活性的检测,结合脱落细胞学检查,探讨端粒酶活性检测在胸腹水和腹腔液良恶性判别中的临床应用价值。方法:采用PCR-TRAP技术检测端粒酶活性,同时进行常规脱落细胞学检查。结果:39例胸腹水及腹腔液标本中端粒酶阳性10例,占25.6%,端粒酶活性与脱落细胞检查符合率为87.2%(34/39),两种检查方法具有一致性(χ2=12.54,P<0.005)。端粒酶检查胸腹腔液的敏感性为85.7%(6/7),特异性为87.5%(28/32)。12例胃肠癌端粒酶活性均为阳性,腹腔液的端粒酶活性与原发灶浸润深度及淋巴结转移有关(u=2.38,P<0.05)。结论:端粒酶检测与脱落细胞检查联合应用有助于提高诊断的敏感性及确诊率。
OBJECTIVE: To investigate the clinical application of telomerase activity detection in benign and malignant pleural, ascites and peritoneal fluid by detecting the activity of telomerase in 39 samples of pleural, ascites and peritoneal fluid and 12 cases of gastrointestinal cancers, combined with exfoliative cytology value. Methods: The telomerase activity was detected by PCR-TRAP and routine exfoliated cytology was performed. Results: The telomerase positive in 39 samples of pleural, ascites and peritoneal fluid were found in 10 cases (25.6%). The coincidence rate of telomerase activity and exfoliated cells was 87.2% (34/39) = 12.54, P <0.005). The sensitivity of telomerase in detecting pleural fluid was 85.7% (6/7) and the specificity was 87.5% (28/32). The telomerase activity of 12 cases of gastrointestinal cancer was positive. The telomerase activity of peritoneal fluid was related to the depth of invasion and lymph node metastasis (u = 2.38, P <0.05). Conclusion: Combined use of telomerase and exfoliated cytology can improve the diagnostic sensitivity and diagnosis.