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目的 探讨胸腔积液脱落细胞ＤＮＡ 定量分析对恶性胸腔积液的诊断价值。方法 采用流式细胞仪（ＦＣＭ） 对７２ 例恶性胸腔积液和５８ 例良性胸腔积液做ＤＮＡ 定量分析，并同时与胸膜活检病理诊断，胸腔积液细胞学诊断及胸腔积液ＣＥＡ 测定等方法相比较。结果 以异倍体阳性为标准，ＦＣＭ 诊断恶性胸腔积液的敏感性为８０ ．６ ％ ，特异性为１００ ．０ ％ ，与胸膜活检病理诊断（８６ ．１ ％ ） 相比较，无显著性差异（ Ｐ＞ ０ ．０５） ，但显著高于胸腔积液细胞学诊断（３６ ．１ ％ ） 及胸腔积液ＣＥＡ 测定（５０ ．０ ％ ） 的阳性率（ Ｐ均＜ ０ ．０１） 。在７２ 例恶性胸腔积液中，有６ 例胸膜活检病理诊断和胸腔积液细胞学诊断均为阴性而异倍体却为阳性，若４ 种方法相结合，其诊断的阳性率达９８ ．０ ％ ，特异性为１００ ．０ ％ 。结论 采用流式细胞仪（ＦＣＭ） 进行胸腔积液脱落细胞ＤＮＡ 定量分析是诊断恶性胸腔积液有效的辅助方法，可弥补病理诊断及细胞学诊断的不足。
Objective To investigate the diagnostic value of DNA quantitative analysis of pleural effusion exfoliated cells in malignant pleural effusions. Methods Fifty-two cases of malignant pleural effusions and 58 cases of benign pleural effusions were analyzed by flow cytometry (FCM). DNA quantification was performed simultaneously with pleural biopsy, pathological diagnosis of pleural effusion, cytology of pleural effusion, CEA determination of pleural effusion, and other methods. Compared. Results The sensitivity of FCM in the diagnosis of malignant pleural effusion was 80 with the criteria of positive heteroploidy. 6 %, specificity is 100. 0 % was not significantly different from the pathological diagnosis of pleural biopsy (86.1 %) (P>0.05), but significantly higher than that of pleural effusion cytology (36.1 %) and pleural effusion CEA The positive rate (50.0%) was determined (P <0.01). Among 72 cases of malignant pleural effusions, 6 cases were diagnosed as pleural biopsy and pleural effusion cytology were negative while heteroploid was positive. If the four methods were combined, the positive rate of diagnosis was 98%. 0 %, specificity 100. 0 %. Conclusion The use of flow cytometry (FCM) for quantitative analysis of exfoliated cells in pleural effusions is an effective method for the diagnosis of malignant pleural effusions, which can make up for the lack of pathological diagnosis and cytological diagnosis.