胸腔积液端粒酶活性检测及其临床意义

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1、［文章编号］10()().2200(2004)03-0231-04临床医学胸腔积液端粒酶活性检测及其临床意义高华,王安潮，陈余清,徐凤珍，刘超［摘耍］冃的:探讨端粒嗨活性测定对恶性与良性胸腔积液的诊断与鉴别诊断价值。方法:采用聚合酶链反应-酚联免疫吸附分析fe(PCR-EIJSA)检测43例恶性胸腔积液和24例良性胸腔积液的端粒酶活性，并与胸腔积液细胞学及癌胚抗原(CEA)测定结果进行比较。结果:恶性胸腔积液组端粒酶阳性率为74.42%,R性胸腔积液组阳性率为12.5()%,差异有显著性("V().()05)；端粒酚活性检测对恶性胸腔积液诊断敏感性为74.42%,特

2、异性为87.5%o恶性胸腔积液组胸腔积液细胞学检查与CEA测定阳性率分别为51.16%和46.51%,均低于端粒酶活性检测3<().()1)。结论:胸腔积液端粒酶活性检测对恶性胸腔积液诊断有重要价值，与细胞学检查、CEA测定联合应用可提高恶性胸腔积液的诊断率。［关键词］胸腔积液；端粒酚;聚合酚链反应-酚联免疫吸附分析法；细胞学技术；癌胚抗原［中国图书资料分类法分类号］R561.3［文献标识码］Alelomeraseactivityinpleuraleffusions:DetectionanditsclinicalsignificanceGAOHua,WANGAn-c

3、hao,CHENYu-qing,XUFcng-zhcn,LIUChao(DepartmentofRespiratoryDiseases,AffiliateciHospitalofBengbuMedicalCollege,Anhui233004,China)［AbstractObjective：Todetemiinethediagnosticvalueofpleuralfluidtelomeraseactivityindistinguishingamalignantfromanonmalignantpleuraleffusion.Methods：UsingaP('R(

4、［x)lymerasechainreaction)-basedTRAP(telomericrepeatamplificationprotocol)assaycombinedwithELISA(enzyme-linkedimmunosorbentassay),wcexaminedtelomeraseactivityinthepleuralfluidcellsobtainedfrom43patientswithmalignantneoplasmsand24patientswithbenignlesions.Theresultwascomparedwiththatbycy

5、tologicaldiagnosisanddeterminationofcarcinocmbryonicantigcn(CEA).Results:1'hcpresenceoftelomeraseactivitywasobservedin32of43samplesofmalignantpleuraleffusions,andin3of24samplesofnonmaligantpleuraleffusions.ThedifferencewassignificantPV0.005).Thedetectionoftelomeraseactivityhadasensitiv

6、ityof74.42%tothediagnosisofmalignantpleuraleffusionsandaspecificityof87.5%,respectively.Theoverallpositiveratein43malignantpleuraleffusioncellsamplesbycytologicalexaminationandbythedeterminationofCEAwas51.16%and46.51%respectively.7hcpositiveratedetectedbycytologicalexaminationandCEAwas

7、significantlylowerthanthatbytelomeraseactivity(<0.01).Conclusions:Ourresultsindicatethatthedetectionoftelomeraseactivityisofgreatvalueinthediagnosisofmalignantpleuraleffusions.ThediagnosiswillbemorereliableofcombinedwithcytologicalexariiinalionandCEAdetemiination.LKeywords］pleuraleff